University of Maryland School of Public Policy, Van Munching Hall, College Park, MD, 20742, USA.
Curr Hypertens Rep. 2018 May 19;20(6):50. doi: 10.1007/s11906-018-0846-2.
Approximately 65% of adults over 60 years in the USA are hypertensive. Poor dietary habits and sedentary lifestyles are fueling the hypertension epidemic. The effects of higher intakes of fruits and vegetables and whole-grain products on systolic and diastolic blood pressures were analyzed using data at baseline, 6 months, and 12 months on 349 and 573 subjects, respectively, in the control and intervention groups of the Women's Health Trial: Feasibility Study in Minority Populations.
Models for systolic and diastolic blood pressures have been estimated using cross-sectional and longitudinal data in different settings. However, it is important to estimate comprehensive dynamic random effects models that take into account inter-relationships between systolic and diastolic blood pressures as well as the effects of dietary intakes and biomarkers for making robust inferences. There were significantly greater reductions (P < 0.05) between baseline and 12 months in systolic and diastolic blood pressures in the intervention group. Second, ratios of α-tocopherol to energy intakes were negatively and significantly associated with systolic and diastolic blood pressures in the intervention group. Third, the lipid accumulation product was positively associated with systolic and diastolic blood pressures in the control and intervention groups. The estimated coefficients of diastolic and systolic blood pressure variables in the respective models for systolic and diastolic blood pressures showed that combining the two measures as pulse pressure can lead to misleading inferences. Overall, dietary interventions promoting higher consumption of fruits and vegetables and whole-grain products can help lower blood pressures of women in the USA.
在美国，约 65%的 60 岁以上成年人患有高血压。不良的饮食习惯和久坐不动的生活方式是导致高血压流行的原因。使用 Women's Health Trial: Feasibility Study in Minority Populations 中对照组和干预组的 349 名和 573 名受试者的基线、6 个月和 12 个月的数据，分析了增加水果、蔬菜和全谷物产品的摄入量对收缩压和舒张压的影响。
在不同环境下，使用横断面和纵向数据对收缩压和舒张压进行了模型估计。然而，重要的是要估计全面的动态随机效应模型，该模型考虑到收缩压和舒张压之间的相互关系，以及饮食摄入和生物标志物的影响，以便做出稳健的推断。干预组的收缩压和舒张压在基线和 12 个月之间的降低幅度显著更大（P<0.05）。其次，干预组中 α-生育酚与能量摄入量的比值与收缩压和舒张压呈负相关。第三，在对照组和干预组中，脂质蓄积产物与收缩压和舒张压呈正相关。在收缩压和舒张压各自模型中收缩压和舒张压变量的估计系数表明，将这两个指标组合为脉压可能会导致误导性推断。总的来说，促进增加水果、蔬菜和全谷物产品摄入的饮食干预可以帮助降低美国女性的血压。
