Effects of Ramadan Fasting on Blood Pressure in Hypertensive Patients: A Systematic Review

Document Type : Review Article

Authors

1 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2- Patient safety research center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Ramadan is a holy month for Muslims and fasting in this month is the rule for any healthy matured person. Nutritional and behavioral changes occurred during Ramadan fasting may lead to several physiological change, such as blood pressure (2). Studies evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients, are scarce and reported inadequate results. In this paper a systematic review was performed to accumulate the results of published literature designed to evaluate blood pressure changes in hypertensive patients due to Ramadan fasting. All prospective, English studies which evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients and measured systolic and diastolic blood pressure twice at least ( before Ramadan and during last week of Ramadan or after Ramadan fasting ) were included in systematic review. Five studies reported the effect of Ramadan fasting on blood pressure in hypertensive patients in full text. Although significant reduction in systolic blood pressure during Ramadan fasting were seen in 3 studies (3-5), other 3 studies reported no significant difference between systolic blood pressure before and after Ramadan fasting (6, 7). Among 6 studies that reviewed in this paper, 4 studies reported no significant changes in diastolic blood pressure (4, 6, 7). While 2 other studies reported significant reduction in systolic blood pressure after Ramadan fasting (3, 5). This systematic review suggested that Ramadan fasting can be safe in treated essential hypertensive patients with continuation of previous medications. Also it can improve systolic and diastolic blood pressures.

Keywords


  1. Habbal R, Azzouzi L, Adnan K, Tahiri A, Chraibi N. Variations of blood pressure during the month of Ramadan. Arch Mal Coeur Vaiss. 1998; 91(8):995-8.

  2. Azizi F. Research in Islamic fasting and health. Ann Saudi Med. 2002; 22(3-4):186-91.
  3. Salahuddin M, Sayed Ashfak AH, Syed SR, Badaam KM. Effect of Ramadan fasting on body weight, (BP) and biochemical parameters in middle aged hypertensive subjects: an observational trial. J Clin Diagn Res. 2014; 8(3):16-8.
  4. Al-Shafei AI. Ramadan fasting ameliorates arterial pulse pressure and lipid profile, and alleviates oxidative stress in hypertensive patients. Blood Pressure. 2014; 23(3):160-7.
  5. Akturk IF, Biyik I, Kosas C, Yalcin AA, Erturk M, Uzun F. Effects of Ramadan fasting on blood pressure control, lipid profile, brain natriuretic peptide, renal functions and electrolyte levels in hypertensive patients taking combination therapy. Evaluation. 2013; 21:25.
  6. Ural E, Kozdag G, Kilic T, Ural D, Sahin T, Celebi O, et al. The effect of Ramadan fasting on ambulatory blood pressure in hypertensive patients using combination drug therapy. J Hum Hypertens. 2008; 22(3):208-10.
  7. Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens. 2001; 15(10):723-5.
  8. World Health Organization. Global health risks report: mortality and burden of disease attributable to selected major risks. Genova: World Health Organization; 2009.
  9. Beltaifa L, Bouguerra R, Ben Slama C, Jabrane H, El-Khadhi A, Ben Rayana MC, et al. Food intake, and anthropometrical and biological parameters in adult Tunisians during fasting at Ramadan. East Mediterr Health J. 2002; 8(4-5):603-11.
  10. Bouguerra R, Belkadhi A, Jabrane J, Hamzaoui J, Maatki C, Ben Rayana MC, et al. Metabolic effects of the month of Ramadan fasting on type 2 diabetes. East Mediterr Health J. 2003; 9(5-6):1099-108.
  11. Bouguerra R, Jabrane J, Maatki C, Ben Salem L, Hamzaoui J, El Kadhi A, et al. Ramadan fasting in type 2 diabetes mellitus. Ann Endocrinol. 2006; 67(1):54-9.
  12. Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012; 11(1):69.
  13. Sayedda K, Kamal S, Ahmed QS. Effect of Ramadan fasting on anthropometric parameters, blood pressure, creatine phosphokinase activity, serum calcium and phosphorus in healthy students of Shri Ram Murti Smarak institute of medical sciences, Bareilly-UP. Natl J Physiol Pharm Pharmacol. 2013; 3(1):48-52.
  14. Mann DL, Zipes DP, Libby P, Bonow RO. Braunwald’s heart disease: a textbook of cardiovascular medicine. 10 th ed. New York: Elsevier Health Sciences; 2015.
  15. Benchekroun MT, Moussamih S. Effects of Ramadan fasting on cardiovascular diseases. Saudi Med J. 2004; 25(10):1520-1.
  16. Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Curr Med Res Opin. 2013; 29(4):343-54.
  17. Khosropanah S, Ashraf F, Handjani AM. The effect of one-day Ramadan fast on blood pressure of hyprtensive patients. Iran Heart J. 2003; 4:39-43.