Leblay Lise, Bélanger Amélie, Desjardins Clémence, Filiatrault Mathieu, Paquette Jean-Sébastien, Drouin-Chartier Jean-Philippe
Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, Québec, Canada.
Faculté de Pharmacie, Université Laval, Québec City, Québec, Canada.
CJC Open. 2023 Sep 28;6(1):30-39. doi: 10.1016/j.cjco.2023.09.016. eCollection 2024 Jan.
Management of high blood pressure (BP), a key feature of the metabolic syndrome (MetS), relies on diet and medication. Whether these modalities are used as complements has never been evaluated in real-world settings. This study assessed the relationship between diet quality and antihypertensive medication intensity among adults with MetS-associated high BP.
This cross-sectional study included 915 adults with MetS-associated high BP from the CARTaGENE cohort (Québec, Canada), of whom 677 reported using BP-lowering medication. Antihypertensive medication intensity was graded per the number of BP-lowering classes used simultaneously. Diet quality was assessed using the ietary pproach to top ypertension (DASH) score.
No evidence of a relationship between antihypertensive medication intensity and diet quality was found (β for each additional antihypertensive = -0.05; 95% CI, -0.35; 0.26 DASH score points). However, among men aged < 50 years and women aged < 60 years, the DASH score was inversely associated with medication intensity (β = -0.72; 95% CI, -1.24, -0.19), whereas this relationship tended to be positive among older participants (β = 0.32; 95% CI, -0.05, 0.69). Among participants with low Framingham risk score, the DASH score was inversely associated with medication intensity (β = -0.70; 95% CI, -1.31, -0.09), but no evidence of an association was found among individuals at moderate (β = 0.00; 95% CI, -0.45, 0.45) or high (β = 0.30, 95% CI, -0.24, 0.84) risk.
In this cohort of adults with MetS-associated high BP, there was an overall lack of complementarity between diet quality and BP-lowering medication, especially among younger individuals and those with a lower risk for cardiovascular disease for whom diet quality was inversely associated with intensity of medication.
高血压是代谢综合征（MetS）的一个关键特征，其管理依赖于饮食和药物治疗。在现实环境中，这些方式是否相互补充从未得到评估。本研究评估了患有MetS相关高血压的成年人的饮食质量与降压药物强度之间的关系。
这项横断面研究纳入了来自CARTaGENE队列（加拿大魁北克）的915名患有MetS相关高血压的成年人，其中677人报告正在使用降压药物。根据同时使用的降压药物类别数量对降压药物强度进行分级。使用饮食预防高血压（DASH）评分评估饮食质量。
未发现降压药物强度与饮食质量之间存在关联的证据（每增加一种降压药物的β值=-0.05；95%可信区间，-0.35；0.26 DASH评分点）。然而，在年龄小于50岁的男性和年龄小于60岁的女性中，DASH评分与药物强度呈负相关（β=-0.72；95%可信区间，-1.24，-0.19），而在年龄较大的参与者中这种关系倾向于呈正相关（β=0.32；95%可信区间，-0.05，0.69）。在弗明汉风险评分较低的参与者中，DASH评分与药物强度呈负相关（β=-0.70；95%可信区间，-1.31，-0.09），但在中度（β=0.00；95%可信区间，-0.45，0.45）或高度（β=0.30，95%可信区间，-0.24，0.84）风险的个体中未发现关联证据。
在这个患有MetS相关高血压的成年人群体中，饮食质量与降压药物之间总体上缺乏互补性，尤其是在较年轻个体以及心血管疾病风险较低的个体中，饮食质量与药物强度呈负相关。
