From the Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (E.T., L.J.A., H.-C.Y., S.J.P., E.R.M., N.M.M.).
Welch Center for Prevention, Epidemiology, & Clinical Research, Johns Hopkins University, Baltimore, MD (E.T., L.J.A., H.-C.Y., S.J.P., E.R.M., N.M.M.).
Hypertension. 2021 Feb;77(2):265-274. doi: 10.1161/HYPERTENSIONAHA.120.14584. Epub 2020 Dec 21.
Elevated blood pressure and blood pressure-related morbidity are extraordinarily common in persons with diabetes. The Dietary Approaches to Stop Hypertension dietary pattern and dietary sodium reduction are recommended as lifestyle interventions in individuals with diabetes. However, these recommendations have largely been based on studies conducted in persons without diabetes. In this review, we summarize available evidence from trials that tested the effects of these 2 dietary interventions on blood pressure in people with diabetes. Overall, of the 3 trials (total n=151) that tested the effects of the Dietary Approaches to Stop Hypertension dietary pattern in persons with diabetes, 2 trials documented that the Dietary Approaches to Stop Hypertension dietary pattern lowered blood pressure. While 16 trials (total n=445) tested the effects of sodium reduction in persons with diabetes, results were inconsistent, likely because of design limitations, for example, brief duration, small sample size, and low baseline blood pressure levels, as well as differences in the mode of intervention delivery (behavioral interventions, feeding studies, and sodium supplements). In conclusion, there is a substantial need for additional research on the blood pressure lowering effects of the Dietary Approaches to Stop Hypertension diet and sodium reduction in people with diabetes and hypertension, given the high prevalence of hypertension and the dearth of high-quality trials in this population.
高血压和与血压相关的发病率在糖尿病患者中极为常见。推荐采用停止高血压的饮食方法（Dietary Approaches to Stop Hypertension，DASH）饮食模式和减少饮食中的钠摄入作为糖尿病患者的生活方式干预措施。然而，这些建议主要基于在非糖尿病患者中进行的研究。在这篇综述中，我们总结了来自试验的现有证据，这些试验测试了这两种饮食干预措施对糖尿病患者血压的影响。总的来说，在 3 项试验（共 151 人）中测试了停止高血压的饮食方法对糖尿病患者血压的影响，其中 2 项试验记录了停止高血压的饮食方法可以降低血压。虽然有 16 项试验（共 445 人）测试了减少钠摄入对糖尿病患者的影响，但结果不一致，这可能是由于设计上的限制，例如干预的持续时间短、样本量小、基线血压水平低，以及干预方式的差异（行为干预、喂养研究和钠补充剂）。总之，鉴于高血压在糖尿病和高血压患者中的高患病率以及该人群中高质量试验的缺乏，迫切需要进一步研究停止高血压的饮食方法和减少钠摄入对降低糖尿病患者血压的影响。
