Abstract：
Exogenous ketone supplements have been suggested to have potential cardiovascular benefits, but their overall effect on blood pressure is unclear. Our objective was to perform a systematic review and meta-analysis on the effects of exogenous ketone supplements on blood pressure (BP) and concomitant changes in resting heart rate (HR). Five databases were searched on January 27th, 2023, for randomized and non-randomized studies. A random-effects model meta-analysis was performed including all studies jointly and separately for acute and chronic ingestion of ketone supplements. Out of 4012 studies identified in the search, 4 acute and 6 chronic studies with n = 187 participants were included. Pooled results (n = 10) showed no change in systolic (SMD [95% CI]= -0.14 [-0.40; 0.11]; I2= 30%; p = 0.17) or diastolic BP (-0.12 [-0.30; 0.05]; I2= 0%; p = 0.69), with a potential tendency observed toward increased resting heart rate (0.17 [-0.14; 0.47]; I2= 40%; p = 0.10). Similar results for systolic and diastolic BP were observed when assessing separately the effect of acute and chronic ingestion of ketone supplements (p ≥ 0.33). Supplement dosage was found to modulate the increase in resting heart rate (0.019 ± 0.006; p = 0.013; R2=100%), suggesting that higher supplement doses lead to a higher resting heart rate. Based on currently available data, acute or prolonged ingestion of ketone supplements does not seem to modulate BP. However, a tendency for HR to increase after acute ingestion was observed, particularly with higher doses. Higher quality studies with appropriate standardized measurements are needed to confirm these results.
摘要：
外源性酮补充剂已被认为具有潜在的心血管益处，但它们对血压的总体影响尚不清楚。我们的目的是对外源性酮补充剂对血压（BP）和静息心率（HR）伴随变化的影响进行系统评价和荟萃分析。1月27日搜索了五个数据库，2023年，用于随机和非随机研究。进行了随机效应模型荟萃分析，包括所有针对急性和慢性摄入酮补充剂的联合和单独研究。在搜索中确定的4012项研究中，包括4项急性和6项慢性研究，n=187名参与者。汇总结果(n=10)显示收缩压(SMD[95%CI]=-0.14[-0.40;0.11];I2=30%;p=0.17)或舒张压(-0.12[-0.30;0.05];I2=0%;p=0.69)无变化,观察到静息心率增加的潜在趋势（0.17[-0.14;0.47];I2=40％;p=0.10）。当分别评估急性和慢性服用酮补充剂的效果时，观察到收缩压和舒张压的结果相似（p≥0.33）。发现补充剂量可以调节静息心率的增加（0.019±0.006;p=0.013;R2=100％），表明更高的补充剂量会导致更高的静息心率。根据现有数据，急性或长期服用酮补充剂似乎不能调节血压。然而,观察到急性摄入后HR增加的趋势，特别是高剂量。需要具有适当标准化测量的高质量研究来证实这些结果。
