饮食中减少钠摄入及终止高血压膳食疗法（DASH）对血压的影响。DASH-钠联合研究小组。

Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.

作者信息

Sacks F M, Svetkey L P, Vollmer W M, Appel L J, Bray G A, Harsha D, Obarzanek E, Conlin P R, Miller E R, Simons-Morton D G, Karanja N, Lin P H

机构信息

Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.

出版信息

N Engl J Med. 2001 Jan 4;344(1):3-10. doi: 10.1056/NEJM200101043440101.

DOI:10.1056/NEJM200101043440101

PMID:11136953

Abstract

BACKGROUND

The effect of dietary composition on blood pressure is a subject of public health importance. We studied the effect of different levels of dietary sodium, in conjunction with the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in vegetables, fruits, and low-fat dairy products, in persons with and in those without hypertension.

METHODS

A total of 412 participants were randomly assigned to eat either a control diet typical of intake in the United States or the DASH diet. Within the assigned diet, participants ate foods with high, intermediate, and low levels of sodium for 30 consecutive days each, in random order.

RESULTS

Reducing the sodium intake from the high to the intermediate level reduced the systolic blood pressure by 2.1 mm Hg (P<0.001) during the control diet and by 1.3 mm Hg (P=0.03) during the DASH diet. Reducing the sodium intake from the intermediate to the low level caused additional reductions of 4.6 mm Hg during the control diet (P<0.001) and 1.7 mm Hg during the DASH diet (P<0.01). The effects of sodium were observed in participants with and in those without hypertension, blacks and those of other races, and women and men. The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level; and the difference was greater with high sodium levels than with low ones. As compared with the control diet with a high sodium level, the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension, and 11.5 mm Hg lower in participants with hypertension.

CONCLUSIONS

The reduction of sodium intake to levels below the current recommendation of 100 mmol per day and the DASH diet both lower blood pressure substantially, with greater effects in combination than singly. Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods.

摘要

背景

饮食结构对血压的影响是一个具有公共卫生重要性的课题。我们研究了不同水平的膳食钠，结合富含蔬菜、水果和低脂乳制品的终止高血压膳食疗法（DASH）饮食，对有高血压和无高血压人群的影响。

方法

总共412名参与者被随机分配食用美国典型的对照饮食或DASH饮食。在分配的饮食中，参与者分别连续30天随机食用高、中、低水平钠的食物。

结果

在对照饮食期间，将钠摄入量从高水平降至中等水平可使收缩压降低2.1毫米汞柱（P<0.001），在DASH饮食期间降低1.3毫米汞柱（P=0.03）。将钠摄入量从中等水平降至低水平，在对照饮食期间可使收缩压进一步降低4.6毫米汞柱（P<0.001），在DASH饮食期间降低1.7毫米汞柱（P<0.01）。在有高血压和无高血压的参与者、黑人和其他种族的参与者以及女性和男性中均观察到了钠的影响。在每个钠水平上，DASH饮食与显著更低的收缩压相关；高钠水平时的差异比低钠水平时更大。与高钠水平的对照饮食相比，低钠水平的DASH饮食使无高血压参与者的平均收缩压低7.1毫米汞柱，使有高血压参与者的平均收缩压低11.5毫米汞柱。