Thirty-two observational studies were identified (Table 2).16- 47 These studies included 21 604 participants (median sample size, 152; range, 20-9242) with a mean age of 46.6 years (range, 28.8-68.4 years). Each of the 32 observational studies used cross-sectional designs. As shown in Table 2, several participants in 5 observational studies17,28,32,38,40 used antihypertensive medication. Because pooled effects were not reported, male and female subgroups (10 studies)24,25,32,33,35,36,41,44- 46 and racial subgroups (1 study)40 were included in the subgroup analyses (Table 2). In 22 of these studies, participants had been following vegetarian diets for more than 1 year.16- 20,22- 24,26- 31,33,37,39- 43,45 Five studies focused on vegan diets,23,27,31,39,41 2 on lacto-vegetarian diets,18,24 10 on lacto-ovo-vegetarian diets,16,19,20,22,26,29,37,43,44,47 and 15 on mixed diet types (vegan, lacto, lacto-ovo, pesco, and/or semivegetarian).17,21,25,28,30,32- 36,38,40,42,45,46 In 20 studies, diets were assessed by using questionnaires, typically food frequency questionnaires17,29,32,34,35,38,40 or 24-hour diet recalls.16,20,22,25,27,31,33,37,39,41,42,44,45 Interviews or self-report were used in 7 studies,18,19,24,28,36,43,47 and weighing methods were used for 1 study21; the means of dietary assessment were not reported in 4 studies.23,26,30,46 Of the 32 observational studies, 12 conducted repeated measurements of BP.16- 18,24,27,28,31,34,35,38,40,44 The adjusted factors in each study are shown in the Supplement (eTable 2).