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高血压的营养疗法。一项为期四年的随机对照试验——高血压控制项目的最终报告。

Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial--the Hypertension Control Program.

作者信息

Stamler R, Stamler J, Grimm R, Gosch F C, Elmer P, Dyer A, Berman R, Fishman J, Van Heel N, Civinelli J

出版信息

JAMA. 1987 Mar 20;257(11):1484-91. doi: 10.1001/jama.257.11.1484.

Abstract

A four-year trial assessed whether less severe hypertensives could discontinue antihypertensive drug therapy, using nutritional means to control blood pressure. Randomization was to three groups: group 1--discontinue drug therapy and reduce overweight, excess salt, and alcohol; group 2--discontinue drug therapy, with no nutritional program; or group 3--continue drug therapy, with no nutritional program. In groups 1 and 2 patients resumed drug therapy if pressure rose to hypertensive levels. Loss of at least 4.5 kg (10 + lb) was maintained by 30% of group 1, with a group mean loss of 1.8 kg (4 lb); sodium intake fell 36% and modest alcohol intake reduction was reported. At four years, 39% in group 1 remained normotensive without drug therapy, compared with 5% in group 2. Study findings demonstrated that nutritional therapy may substitute for drugs in a sizable proportion of hypertensives or, if drugs are still needed, can lessen some unwanted biochemical effects of drug treatment.

摘要

一项为期四年的试验评估了病情较轻的高血压患者是否可以停用降压药物治疗,采用营养手段来控制血压。患者被随机分为三组:第一组——停用药物治疗并减少超重、过量盐分和酒精摄入;第二组——停用药物治疗,不进行营养计划;第三组——继续药物治疗,不进行营养计划。在第一组和第二组中,如果血压升至高血压水平,患者需恢复药物治疗。第一组中30%的患者体重至少减轻了4.5千克(10磅以上),该组平均体重减轻1.8千克(4磅);钠摄入量下降了36%,且据报告酒精摄入量有适度减少。四年后,第一组中39%的患者在未接受药物治疗的情况下血压仍保持正常,而第二组这一比例为5%。研究结果表明,营养疗法在相当一部分高血压患者中可以替代药物治疗,或者在仍需要药物治疗时,可以减轻药物治疗的一些不良生化影响。

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