Wassertheil-Smoller S, Blaufox M D, Langford H G, Oberman A, Cutter G, Pressel S
J Hypertens Suppl. 1986 Dec;4(5):S343-6.
In the Dietary Intervention Study of Hypertension (DISH) we found that patients formerly treated with drugs and assigned to sodium-reduction intervention were twice as likely to remain off medication for up to 56 weeks as were the controls assigned to no-diet intervention, after adjusting for covariates. Within the sodium-restriction group approximately 60% of 131 people were Intervention Successes (IS) (urinary sodium less than or equal to 100 mmol/day at 8 weeks). The rest were classed as Non-Intervention Successes (NIS). Of the IS group, 54% were responders (drug-free for at least 56 weeks), but about 56% of the NIS group also remained drug-free. Multiple logistics showed that no one factor was able to predict response among the IS. We conclude that the IS likely to respond to sodium reduction are not readily identifiable a priori. Furthermore, since both IS and NIS showed similar blood-pressure effects from the sodium-restriction regimen compared with controls, the questions arise: whether a factor other than sodium reduction affects the blood pressure response for the sodium-restriction group; or whether the measurement of sodium intake and excretion is sufficiently precise to distinguish compliers from non-compliers.
在高血压饮食干预研究（DISH）中，我们发现，在对协变量进行调整后，以前接受过药物治疗并被分配到减钠干预组的患者，与被分配到非饮食干预组的对照组相比，在长达56周的时间内停用药物的可能性高出一倍。在限钠组中，131人中有约60%为干预成功（IS）者（8周时尿钠小于或等于100 mmol/天）。其余的被归类为非干预成功（NIS）者。在IS组中，54%为反应者（至少56周无药物治疗），但NIS组中约56%的人也保持无药物治疗状态。多元逻辑分析显示，没有一个因素能够预测IS组中的反应情况。我们得出结论，事先无法轻易识别出可能对减钠有反应的IS者。此外，由于与对照组相比，IS组和NIS组在限钠方案下均显示出相似的血压效应，因此出现了以下问题：除了减钠之外，是否有其他因素影响限钠组的血压反应；或者钠摄入和排泄的测量是否足够精确，以区分依从者和非依从者。
