增加富含硝酸盐蔬菜的摄入量可降低（预）高血压中老年人群的动态血压：一项为期12周的随机对照试验。

Increasing Nitrate-Rich Vegetable Intake Lowers Ambulatory Blood Pressure in (pre)Hypertensive Middle-Aged and Older Adults: A 12-Wk Randomized Controlled Trial.

作者信息

van der Avoort Cindy M T, Ten Haaf Dominique S M, Bongers Coen C W G, van Oorschot Frederieke, Verdijk Lex B, van Loon Luc J C, Hopman Maria T E

机构信息

School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, The Netherlands.

Institute of Sport and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.

出版信息

J Nutr. 2021 Sep 4;151(9):2667-2679. doi: 10.1093/jn/nxab157.

DOI:10.1093/jn/nxab157

PMID:34236392

Abstract

BACKGROUND

Emerging evidence suggests that increasing dietary nitrate intake may be an effective approach to improve cardiovascular health. However, the effects of a prolonged elevation of nitrate intake through an increase in vegetable consumption are understudied.

OBJECTIVE

Our primary aim was to determine the impact of 12 wk of increased daily consumption of nitrate-rich vegetables or nitrate supplementation on blood pressure (BP) in (pre)hypertensive middle-aged and older adults.

METHODS

In a 12-wk randomized, controlled study (Nijmegen, The Netherlands), 77 (pre)hypertensive participants (BP: 144 ± 13/87 ± 7 mmHg, age: 65 ± 10 y) either received an intervention with personalized monitoring and feedback aiming to consume ∼250-300 g nitrate-rich vegetables/d (∼350-400 mg nitrate/d; n = 25), beetroot juice supplementation (400 mg nitrate/d; n = 26), or no intervention (control; n = 26). Before and after intervention, 24-h ambulatory BP was measured. Data were analyzed using repeated measures ANOVA (time × treatment), followed by within-group (paired t-test) and between-group analyses (1-factor ANOVA) where appropriate.

RESULTS

The 24-h systolic BP (SBP) (primary outcome) changed significantly (P-interaction time × treatment = 0.017) with an increase in the control group (131 ± 8 compared with 135 ± 10 mmHg; P = 0.036); a strong tendency for a decline in the nitrate-rich vegetable group (129 ± 10 compared with 126 ± 9 mmHg; P = 0.051) which was different from control (P = 0.020); but no change in the beetroot juice group (133 ± 11 compared with 132 ± 12 mmHg; P = 0.56). A significant time × treatment interaction was also found for daytime SBP (secondary outcome, P = 0.011), with a significant decline in the nitrate-rich vegetable group (134 ± 10 compared with 129 ± 9 mmHg; P = 0.006) which was different from control (P = 0.010); but no changes in the beetroot juice (138 ± 12 compared with 137 ± 14 mmHg; P = 0.41) and control group (136 ± 10 compared with 137 ± 11 mmHg; P = 0.08). Diastolic BP (secondary outcome) did not change in any of the groups.

CONCLUSIONS

A prolonged dietary intervention focusing on high-nitrate vegetable intake is an effective strategy to lower SBP in (pre)hypertensive middle-aged and older adults. This trial was registered at www.trialregister.nl as NL7814.

摘要

背景

新出现的证据表明，增加膳食硝酸盐摄入量可能是改善心血管健康的有效方法。然而，通过增加蔬菜摄入量使硝酸盐摄入量长期升高的影响尚未得到充分研究。

目的

我们的主要目的是确定12周内每日增加富含硝酸盐蔬菜的摄入量或补充硝酸盐对（预）高血压中老年成年人血压（BP）的影响。

方法

在一项为期12周的随机对照研究（荷兰奈梅亨）中，77名（预）高血压参与者（血压：144±13/87±7 mmHg，年龄：65±10岁）要么接受旨在每日摄入约250 - 300克富含硝酸盐蔬菜（约350 - 400毫克硝酸盐/天；n = 25）的个性化监测和反馈干预，要么接受甜菜根汁补充剂（400毫克硝酸盐/天；n = 26），要么不接受干预（对照组；n = 26）。干预前后测量动态血压24小时。使用重复测量方差分析（时间×治疗）进行数据分析，随后在适当时进行组内（配对t检验）和组间分析（单因素方差分析）。

结果

24小时收缩压（SBP）（主要结果）有显著变化（P交互作用时间×治疗 = 0.017），对照组升高（131±8 mmHg与135±10 mmHg相比；P = 0.036）；富含硝酸盐蔬菜组有明显下降趋势（129±10 mmHg与126±9 mmHg相比；P = 0.051），与对照组不同（P = 0.020）；但甜菜根汁组无变化（133±11 mmHg与132±12 mmHg相比；P = 0.56）。白天收缩压（次要结果）也发现了显著的时间×治疗交互作用（P = 0.011），富含硝酸盐蔬菜组有显著下降（134±10 mmHg与129±9 mmHg相比；P = 0.006），与对照组不同（P = 0.010）；但甜菜根汁组（138±12 mmHg与137±14 mmHg相比；P = 0.41）和对照组（136±10 mmHg与137±11 mmHg相比；P = 0.08）无变化。舒张压（次要结果）在任何组中均无变化。