Hikmat Fadi, Appel L J
1] Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA [2] Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
1] Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA [2] Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA [3] Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Hum Hypertens. 2014 Mar;28(3):170-5. doi: 10.1038/jhh.2013.52. Epub 2013 Sep 26.
In the Dietary Approach to Stop Hypertension (DASH) trial, the DASH diet reduced blood pressure (BP) in a diverse sample of US adults. Subsequent analyses of this trial documented the efficacy of the DASH diet in several subgroups. Although subgroup analyses in individuals with metabolic syndrome (MS) have not been performed, the DASH diet has been recommended in MS patients. This paper is a subgroup analysis of the DASH trial, in which we examined the effect of study diets on BP in participants with and without MS. Participants were stratified according to MS status (99 with MS, 311 without MS (Non-MS)). The trial was a dietary intervention study in which participants were randomized to receive a control diet, a diet rich in fruits and vegetables, or the DASH diet. Outcomes were (i) the difference in BP between the end and the beginning of intervention and (ii) control of hypertension. We found no significant interaction between MS status and diet assignment on BP (each P-interaction >0.05). In the MS subgroup, the DASH diet compared with the control diet reduced systolic BP by 4.9 mm Hg (P=0.006) and diastolic BP by 1.9 mm Hg (P=0.15). In the Non-MS subgroup, corresponding net BP reductions were 5.2 mm Hg (P<0.001) and 2.9 mm Hg (P<0.001), respectively. The DASH diet controlled hypertension in 75% of hypertensive participants with MS (adjusted odds ratio=9.5 vs the control diet, P=0.05). In conclusion, the DASH diet similarly reduces BP in those with and without MS. Our findings provide direct evidence for existing recommendations.
在“饮食预防高血压（DASH）试验”中，DASH饮食降低了美国成年人多样化样本中的血压（BP）。对该试验的后续分析记录了DASH饮食在几个亚组中的疗效。虽然尚未对代谢综合征（MS）患者进行亚组分析，但已建议MS患者采用DASH饮食。本文是DASH试验的亚组分析，我们研究了研究饮食对有和没有MS的参与者血压的影响。参与者根据MS状态分层（99名患有MS，311名没有MS（非MS））。该试验是一项饮食干预研究，参与者被随机分配接受对照饮食、富含水果和蔬菜的饮食或DASH饮食。结果是：（i）干预结束时与开始时的血压差异；（ii）高血压的控制情况。我们发现MS状态与饮食分配对血压没有显著交互作用（每个P交互作用>0.05）。在MS亚组中，与对照饮食相比，DASH饮食使收缩压降低了4.9 mmHg（P = 0.006），舒张压降低了1.9 mmHg（P = 0.15）。在非MS亚组中，相应的净血压降低分别为5.2 mmHg（P < 0.001）和2.9 mmHg（P < 0.001）。DASH饮食使75%的患有MS的高血压参与者的高血压得到控制（调整后的优势比 = 9.5，与对照饮食相比，P = 0.05）。总之，DASH饮食在有和没有MS的人群中同样能降低血压。我们的研究结果为现有建议提供了直接证据。
