title: The multiple lifestyle modification for patients with prehypertension and hypertension patients: a systematic review protocol.
abstract: BACKGROUND
  The objective of this systematic review is to investigate the effectiveness, efficacy and safety of multiple concomitant lifestyle modification therapies for patients with hypertension or prehypertension.
  
  
  METHODS
  Electronic searches will be performed in the Cochrane Library, OVID, EMBASE, etc, along with manual searches in the reference lists of relevant papers found during electronic search. We will identify eligible randomised controlled trials utilising multiple lifestyle modifications to lower blood pressure. The control could be drug therapy, single lifestyle change or no intervention. Changes in systolic blood pressure and diastolic blood pressure constitute primary end points, and secondary end points include the number of patients meeting the office target blood pressure, the number of patients reporting microvascular or macrovascular complications, etc. We will extract descriptive, methodological and efficacy data from identified randomised controlled trials (RCTs). We will calculate the relative risk for proportion of patients with a normal blood pressure in the experimental group. Dichotomous data will be analysed using risk difference and continuous data using weighted mean differences, both with 95% CI. We will use the χ(2) test and the I(2) statistic to assess heterogeneity. We will use the fixed effects model to compute the efficacy unless there is evidence of heterogeneity. If heterogeneity of effect size persists with respect to blood pressure change, further metaregression will be performed within groups. We will examine the potential for publication bias by using a funnel plot.
  
  
  RESULTS
  We will synthesise results from RCTs which provide more precise and accurate information on the effect of multiple lifestyle changes on blood pressure. The results of this review will increase the understanding of multiple lifestyle modifications for patients with hypertension or prehypertension.
  
  
  BACKGROUND
  Our protocol is registered on PROSPERO (CRD42013006476), http://www.crd.your.ac.uk/PROSPERO.
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Huai-bin
authors.initials: HB
authors.lastname: Du
authors.affiliation: Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Tian
authors.affiliation: Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People's Republic of China.
authors.forename: Yi-jing
authors.initials: YJ
authors.lastname: Jiang
authors.affiliation: Chengdu Medical College, Chengdu, Sichuan, People's Republic of China.
authors.forename: Shao-lan
authors.initials: SL
authors.lastname: Zhang
authors.affiliation: First Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lu
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Zhen-hong
authors.initials: ZH
authors.lastname: Lai
authors.affiliation: Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
authors.forename: Fan-rong
authors.initials: FR
authors.lastname: Liang
mesh_terms: D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008019:Life Style; D058246:Prehypertension / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012196:Review Literature as Topic; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome