Schröder H, Schmelz E, Marrugat J
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdicca, Barcelona, Spain.
Eur J Nutr. 2002 Aug;41(4):161-7. doi: 10.1007/s00394-002-0372-4.
Hypertension is strongly associated with cardiovascular and renal disease. However, despite the efforts made to control hypertension via drug treatment, prevalence of controlled hypertension could be considered low.
We performed the present study to investigate dietary habits among groups with different blood pressure status (normotensive, non-medicated hypertensive, medicated hypertensive) and to analyze the association between blood pressure and intakes of selected nutrients in normotensive and non-medicated hypertensive subjects (n = 1357), and furthermore in those undergoing hypertension drug treatment (n = 210; controlled and non-controlled).
The present cross-sectional, population-based survey (Gerona, Spain) included cardiovascular risk measurements and analysis of dietary intake with corresponding questionnaires.
Nutrient intake was similar among groups of different blood pressure status after adjusting for sex, age and energy consumption. Multiple linear regression analysis, after adjustment for several confounders, showed that dietary intake of sodium was directly related to blood pressure. The same was seen for the sodium to potassium ratio and both were independent of hypertension drug treatment. In contrast, an inverse association was observed between blood pressure and dietary calcium intake. Moderate sodium (< 2400 mg Na/d) intake reduced the risk of hypertension by 30 % and 52 % (Odds ratio 0.70; 95 % CI 0.52-0.94, respectively) in normotensive and non-medicated hypertensive subjects. Furthermore, moderate sodium in combination with a calcium intake of more than 800 mg/d reduced the risk of inadequate blood pressure control, by 52 % (Odds ratio 0.48; 95 % CI 0.24-0.95) in subjects undergoing hypertension drug treatment. Controlled hypertension subjects have a significantly higher calcium intake than non-controlled.
These results emphasize the importance of diet and overall of sodium intake as non-pharmacological approach in the prevention and treatment of hypertension.
高血压与心血管疾病和肾脏疾病密切相关。然而,尽管通过药物治疗努力控制高血压,但血压得到控制的高血压患病率仍可被认为较低。
我们开展本研究以调查不同血压状态组(血压正常、未用药高血压、用药高血压)的饮食习惯,并分析血压正常和未用药高血压受试者(n = 1357)以及接受高血压药物治疗的受试者(n = 210;血压控制和未控制)中血压与特定营养素摄入量之间的关联。
本次基于人群的横断面调查(西班牙赫罗纳)包括心血管风险测量和通过相应问卷对饮食摄入的分析。
在对性别、年龄和能量消耗进行调整后,不同血压状态组之间的营养素摄入量相似。在对多个混杂因素进行调整后的多元线性回归分析表明,钠的饮食摄入量与血压直接相关。钠钾比也是如此,且两者均与高血压药物治疗无关。相比之下,观察到血压与饮食钙摄入量之间呈负相关。适量摄入钠(<2400 mg钠/天)可使血压正常和未用药高血压受试者的高血压风险分别降低30%和52%(优势比分别为0.70;95%置信区间0.52 - 0.94)。此外,适量摄入钠并结合每天摄入超过800 mg的钙可使接受高血压药物治疗的受试者血压控制不佳的风险降低52%(优势比0.48;95%置信区间0.24 - 0.95)。血压得到控制的高血压受试者的钙摄入量显著高于血压未得到控制的受试者。
这些结果强调了饮食以及总体钠摄入量作为高血压预防和治疗中非药物方法的重要性。