Beckmann S L, Os I, Kjeldsen S E, Eide I K, Westheim A S, Hjermann I
Department of Internal Medicine, Ullevaal Hospital, University of Oslo, Norway.
Am J Hypertens. 1995 Jul;8(7):704-11. doi: 10.1016/0895-7061(95)00122-6.
There is still a need of support for nonpharmacologic treatment of uncomplicated, mild-to-moderate essential hypertension. We investigated whether a low sodium-based diet implemented by a nutritionist could lower blood pressure and affect sympathetic activity. Middle-aged, otherwise healthy men with never-treated essential hypertension (n = 95) were randomized to an intervention group, a blood pressure control group, and a time control group. The intervention group was advised to use less sodium chloride in their diet, and if necessary, less saturated fat and decrease body weight. They attended regular clinic visits as did the blood pressure control group. After 1 year, the intervention group had achieved on average 72 mmol/24 h lower urinary sodium excretion (P < .001) and a decrease in body weight of 2.7 +/- 0.5 kg (P < .001). Both supine and standing mean blood pressure were on average 8 to 10 mm Hg lower after intervention compared with the two control groups (P < .001). Arterial plasma epinephrine, measured in all 40-year-old subjects (n = 30), decreased in parallel in all three groups (P < .05), indicating some habituation to the invasive procedure and clinic visits. However, the decrease in norepinephrine was significant (P < .001) only in the intervention group; it correlated with the weight loss (r = 0.76, P < .05) and was significantly higher (P < .05) than in both control groups. These results suggest that broad dietary advice (ie, low intake of sodium chloride, saturated fat and energy), implemented by a nutritionist, may have a significant blood pressure lowering effect and a favorable sympathicolytic effect in uncomplicated, mild-to-moderate essential hypertension.
对于单纯性轻至中度原发性高血压的非药物治疗，仍需要支持。我们研究了由营养学家实施的低钠饮食是否能降低血压并影响交感神经活动。将未接受过治疗的原发性高血压中年健康男性（n = 95）随机分为干预组、血压控制组和时间对照组。建议干预组在饮食中减少氯化钠的摄入，必要时减少饱和脂肪摄入并减轻体重。他们和血压控制组一样定期到诊所就诊。1年后，干预组平均尿钠排泄量降低了72 mmol/24 h（P < .001），体重减轻了2.7 +/- 0.5 kg（P < .001）。与两个对照组相比，干预后仰卧位和站立位平均血压平均降低了8至10 mmHg（P < .001）。在所有40岁受试者（n = 30）中测量的动脉血浆肾上腺素在三组中均平行下降（P < .05），表明对侵入性操作和诊所就诊有一定的适应性。然而，去甲肾上腺素的下降仅在干预组中显著（P < .001）；它与体重减轻相关（r = 0.76，P < .05），且显著高于两个对照组（P < .05）。这些结果表明，由营养学家实施的广泛饮食建议（即低摄入氯化钠、饱和脂肪和能量）可能对单纯性轻至中度原发性高血压有显著的降压作用和良好的抗交感神经作用。
