Vasdev Sudesh, Stuckless Jennifer
Discipline of Medicine, Faculty of Medicine, Health Sciences Centre, Memorial University, St John's, Newfoundland and Labrador.
Int J Angiol. 2010 Spring;19(1):e7-e20. doi: 10.1055/s-0031-1278362.
Hypertension is a leading cause of morbidity and mortality worldwide. Individuals with hypertension are at increased risk of stroke, heart disease and kidney failure. Both genetic and lifestyle factors, particularly diet, have been attributed an important role in the development of hypertension. Reducing dietary sugar and salt intake can help lower blood pressure; similarly, adequate protein intake may also attenuate hypertension. Observational, cross-sectional and longitudinal epidemiological studies, and controlled clinical trials, have documented significant inverse associations between protein intake and blood pressure. Human and animal studies have shown that specific amino acids within proteins may have antihypertensive effects. Cysteine, glutathione (a tripeptide), glutamate and arginine attenuate and prevent alterations that cause hypertension including insulin resistance, decreased nitric oxide bioavailability, altered renin angiotensin system function, increased oxidative stress and formation of advanced glycation end products. Leucine increases protein synthesis in skeletal muscle and improves insulin resistance by modulating hepatic gluconeogenesis. Taurine and tryptophan attenuate sympathetic nervous system activity. Soy protein helps lower blood pressure through its high arginine content and antioxidant activity exhibited by isoflavones. A diet containing an ample amount of protein may be a beneficial lifestyle choice for individuals with hypertension; one example is the Dietary Approaches to Stop Hypertension (DASH) diet, which is low in salt and saturated fat; includes whole grains, lean meat, poultry, fish and nuts; and is rich in vegetables, fruits and low-fat dairy products, which are good sources of antioxidant vitamins, minerals and fibre. Including an adequate supply of soy in the diet should also be encouraged.
高血压是全球发病和死亡的主要原因。高血压患者患中风、心脏病和肾衰竭的风险增加。遗传和生活方式因素,特别是饮食,在高血压的发生发展中都被认为起着重要作用。减少饮食中的糖和盐摄入量有助于降低血压;同样,充足的蛋白质摄入也可能减轻高血压。观察性、横断面和纵向流行病学研究以及对照临床试验都记录了蛋白质摄入量与血压之间显著的负相关。人体和动物研究表明,蛋白质中的特定氨基酸可能具有降压作用。半胱氨酸、谷胱甘肽(一种三肽)、谷氨酸和精氨酸可减轻和预防导致高血压的改变,包括胰岛素抵抗、一氧化氮生物利用度降低、肾素-血管紧张素系统功能改变、氧化应激增加和晚期糖基化终产物的形成。亮氨酸可增加骨骼肌中的蛋白质合成,并通过调节肝糖异生来改善胰岛素抵抗。牛磺酸和色氨酸可减弱交感神经系统的活动。大豆蛋白因其高含量的精氨酸和异黄酮表现出的抗氧化活性而有助于降低血压。对于高血压患者来说,富含蛋白质的饮食可能是一种有益的生活方式选择;一个例子是终止高血压膳食疗法(DASH)饮食,其盐和饱和脂肪含量低;包括全谷物、瘦肉、家禽、鱼类和坚果;并且富含蔬菜、水果和低脂乳制品,这些都是抗氧化维生素、矿物质和纤维的良好来源。饮食中也应鼓励摄入充足的大豆。