From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.).
Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.).
Hypertension. 2019 May;73(5):1049-1057. doi: 10.1161/HYPERTENSIONAHA.118.12766.
Nut consumption lowers blood cholesterol and is associated with reduced cardiovascular disease, but effects on blood pressure (BP) are inconsistent. We assessed the 2-year effects of a walnut diet versus a control diet on office BP and 24-hours ambulatory BP in free-living elders participating in the Walnuts and Healthy Aging study, a randomized trial testing the effects of walnuts at ≈15% energy on age-related disorders. In a prespecified analysis, we enrolled 305 participants, of whom 236 (75%) completed the study (65% women; age, 69 years; 60% with mild hypertension). Walnuts were well tolerated, and compliance was >98%. Mean baseline office BP was 128/79 mm Hg. Adjusted changes from baseline in mean office systolic BP were -4.61 mm Hg (95% CI, -7.43 to -1.79 mm Hg) in the walnut group and -0.59 mm Hg (-3.38 to 2.21 mm Hg) in controls ( P=0.051). Respective changes in mean systolic 24-hour ambulatory BP were -3.86 mm Hg (CI, -5.45 to -2.26 mm Hg) and -2.00 mm Hg (CI, -3.58 to -0.42 mm Hg; P=0.111). No changes in diastolic BP were observed. In participants in the upper tertile of baseline 24-hour ambulatory systolic BP (>125 mm Hg), mean 2-year systolic 24-hour BP was -8.5 mm Hg (CI, -12 to -5.0 mm Hg) in the walnut group and -2.5 mm Hg (CI, -6.3 to 1.3 mm Hg) in controls ( P=0.034). During the trial, participants in the walnut group required less uptitration of antihypertensive medication and had better overall BP regulation than controls. Walnut consumption reduces systolic BP in elderly subjects, particularly in those with mild hypertension. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT01634841 .
坚果摄入可降低血液胆固醇水平，并降低心血管疾病风险，但对血压（BP）的影响并不一致。我们评估了为期 2 年的核桃饮食与对照饮食对参与核桃与健康老龄化研究的自由生活老年人诊室血压和 24 小时动态血压的影响，这是一项随机试验，旨在测试约 15%能量的核桃对与年龄相关的疾病的影响。在预先指定的分析中，我们纳入了 305 名参与者，其中 236 名（75%）完成了研究（65%为女性；年龄 69 岁；60%患有轻度高血压）。核桃耐受性良好，依从性>98%。基线时诊室平均血压为 128/79mmHg。调整后的组间基线平均诊室收缩压变化为，核桃组下降 4.61mmHg（95%CI：-7.43 至-1.79mmHg），对照组下降 0.59mmHg（95%CI：-3.38 至 2.21mmHg）（P=0.051）。相应的 24 小时动态收缩压变化为，核桃组下降 3.86mmHg（95%CI：-5.45 至-2.26mmHg），对照组下降 2.00mmHg（95%CI：-3.58 至-0.42mmHg）（P=0.111）。舒张压无变化。在基线 24 小时动态收缩压处于上三分位数（>125mmHg）的参与者中，核桃组 2 年平均 24 小时收缩压为-8.5mmHg（95%CI：-12 至-5.0mmHg），对照组为-2.5mmHg（95%CI：-6.3 至 1.3mmHg）（P=0.034）。在试验期间，核桃组参与者需要较少地增加降压药物的剂量，且血压控制总体优于对照组。核桃摄入可降低老年患者的收缩压，尤其是轻度高血压患者。临床试验注册- URL：http://www.clinicaltrials.gov 。独特标识符：NCT01634841 。
