Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Am J Hypertens. 2021 Sep 22;34(9):919-928. doi: 10.1093/ajh/hpab041.
Hypertension (HTN) in pregnancy is a leading cause of maternal morbidity and mortality in the United States. Although the Dietary Approaches to Stop Hypertension (DASH) diet is recommended for all adults with HTN, rates of DASH adherence and antihypertensive medication use in women of child-bearing age are unknown. Our objectives were to determine DASH adherence and antihypertensive medication use in women of child-bearing age.
In the National Health and Nutrition Examination Surveys from 2001 to 2016, we estimated DASH adherence among women of child-bearing age (20-50 years). We derived a DASH score (0-9) based on 9 nutrients, with DASH adherence defined as DASH score ≥4.5. HTN was defined by blood pressure (BP) ≥130/80 mm Hg or antihypertensive medication use. DASH scores were compared across BP categories and antihypertensive medication use was categorized.
Of the 7,782 women, the mean age (SE) was 32.8 (0.2) years, 21.4% were non-Hispanic Black, and 20.3% had HTN. The mean DASH score was 2.11 (0.06) for women with self-reported HTN and 2.40 (0.03) for women with normal BP (P < 0.001). DASH adherence was prevalent in 6.5% of women with self-reported HTN compared with 10.1% of women with normal BP (P < 0.05). Self-reported HTN is predominantly managed with medications (84.8%), while DASH adherence has not improved in these women from 2001 to 2016. Moreover, 39.5% of US women of child-bearing age are taking medications contraindicated in pregnancy.
Given the benefits of optimized BP during pregnancy, this study highlights the critical need to improve DASH adherence and guide prescribing among women of child-bearing age.
高血压（HTN）是美国孕产妇发病率和死亡率的主要原因。虽然建议所有患有 HTN 的成年人采用饮食方法阻止高血压（DASH）饮食，但在育龄妇女中，DASH 依从率和抗高血压药物的使用情况尚不清楚。我们的目的是确定育龄妇女的 DASH 依从率和抗高血压药物的使用情况。
在 2001 年至 2016 年的全国健康和营养调查中，我们估计了育龄妇女（20-50 岁）的 DASH 依从率。我们根据 9 种营养素得出 DASH 评分（0-9），DASH 依从性定义为 DASH 评分≥4.5。高血压的定义为血压（BP）≥130/80mmHg 或使用抗高血压药物。比较了不同 BP 类别和抗高血压药物使用情况的 DASH 评分。
在 7782 名女性中，平均年龄（SE）为 32.8（0.2）岁，21.4%为非西班牙裔黑人，20.3%患有高血压。自我报告患有高血压的女性平均 DASH 评分为 2.11（0.06），血压正常的女性平均 DASH 评分为 2.40（0.03）（P<0.001）。自我报告患有高血压的女性中，DASH 依从性的发生率为 6.5%，而血压正常的女性中，DASH 依从性的发生率为 10.1%（P<0.05）。自我报告的高血压主要通过药物治疗（84.8%），而这些女性的 DASH 依从性从 2001 年到 2016 年并没有改善。此外，39.5%的美国育龄妇女正在服用妊娠期禁忌的药物。
鉴于妊娠期间血压优化的益处，本研究强调了在育龄妇女中提高 DASH 依从性和指导处方的迫切需要。
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