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高血压预防试验的设计、方法及理论依据。高血压预防试验研究组

Design, methods, and rationale in the Hypertension Prevention Trial. Hypertension Prevention Trial Research Group.

作者信息

Meinert C L, Borhani N O, Langford H G

机构信息

Johns Hopkins School of Hygiene and Public Health, Department of Epidemiology, Baltimore, MD 21205.

出版信息

Control Clin Trials. 1989 Sep;10(3 Suppl):1S-29S. doi: 10.1016/0197-2456(89)90040-8.

Abstract

The Hypertension Prevention Trial (HPT) was a randomized, controlled, multicenter (four clinics, four resource centers) trial designed to test the feasibility of achieving and sustaining dietary changes in the intake of calories, sodium, and potassium and to assess the effect of those changes on blood pressure in a normotensive population. The trial involved 841 men and women (plus a test cohort of 78) who, at the first baseline (BL) examination, were in the age range of 25-49 years and had diastolic blood pressure (DBP) greater than or equal to 76 but less than 100 mm Hg (average of two readings), and at the examination prior to randomization (BL 2) had DBP greater than or equal to 78 but less than 90 mm Hg (also averaged). Participants were randomly assigned to a control treatment group (no dietary counseling) or to one of four dietary treatment groups involving counseling designed to reduce calorie intake, reduce sodium intake, reduce sodium and calorie intake, and reduce sodium and increase potassium intake. Dietary counseling was provided primarily in group settings and was aimed at changing participants' shopping, cooking, and eating habits related to a designated treatment assignment. The effect of dietary counseling was measured through changes in urinary excretion of sodium and potassium, changes in body weight, and changes in reported food intake based on 24-hour food records. Blood pressure changes during the 3-year course of followup were based on measurements taken at 6-month intervals from enrollment using a random-zero sphygmomanometer. This chapter provides a general description of the design and methods of the HPT and the underlying rationale for decisions affecting the design.

摘要

高血压预防试验(HPT)是一项随机、对照、多中心(四个诊所、四个资源中心)试验,旨在测试在正常血压人群中实现并维持热量、钠和钾摄入量的饮食变化的可行性,并评估这些变化对血压的影响。该试验涉及841名男性和女性(外加一个78人的测试队列),他们在第一次基线(BL)检查时年龄在25至49岁之间,舒张压(DBP)大于或等于76但小于100毫米汞柱(两次读数的平均值),在随机分组前的检查(BL 2)时DBP大于或等于78但小于90毫米汞柱(也是平均值)。参与者被随机分配到一个对照治疗组(无饮食咨询)或四个饮食治疗组之一,这四个饮食治疗组的咨询旨在减少热量摄入、减少钠摄入、减少钠和热量摄入以及减少钠并增加钾摄入。饮食咨询主要在小组环境中提供,旨在改变参与者与指定治疗任务相关的购物、烹饪和饮食习惯。通过钠和钾的尿排泄变化、体重变化以及基于24小时食物记录的报告食物摄入量变化来衡量饮食咨询的效果。在3年的随访过程中,血压变化基于从入组开始每隔6个月使用随机零血压计进行的测量。本章对HPT的设计和方法以及影响设计决策的基本原理进行了总体描述。

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