Retta T M, Afre G M, Randall O S
Department of Medicine, Howard University Medical Center, Washington, DC.
J Assoc Acad Minor Phys. 1994;5(4):147-51.
Hypertension is a major cause of morbidity and mortality in the United States, particularly in the African-American population. Although there have been indications since the beginning of this century that blood pressure might be influenced by dietary factors, this has been generally ignored, and the mainstay of hypertension treatment has been the use of pharmacologic antihypertensives. Attention is now being focused, however, on dietary management of hypertension because of the high cost of drug therapy, the adverse reactions associated with some antihypertensives, and the fact that hypertensives treated only by pharmacologic means remain at risk for target-organ damage. The literature is replete with evidence that vegetarian and low-sodium dietary patterns are associated with lower blood pressure levels. This implies that if many people could adopt vegetarian and low-salt dietary habits, the prevalence of hypertension would be significantly reduced. However, most people find "unsalted" vegetarian diets tasteless and unacceptable. We therefore need to identify the macro- and micronutrients (other than sodium) that directly influence blood pressure. Several studies indicate that dietary patterns rich in fiber, calcium, potassium, and magnesium are favorable for blood pressure control. This review highlights some of these findings and emphasizes the need for large clinical trials to test blood-pressure-reducing dietary patterns by incorporating the aforementioned macro- and micronutrients into socioculturally acceptable and palatable menus, especially in the African-American population.
高血压是美国发病和死亡的主要原因，在非裔美国人中尤为如此。尽管自本世纪初就有迹象表明血压可能受饮食因素影响，但这一点通常被忽视，高血压治疗的主要手段一直是使用抗高血压药物。然而，由于药物治疗成本高昂、一些抗高血压药物存在不良反应，以及仅通过药物治疗的高血压患者仍面临靶器官损害风险，目前人们的注意力正集中在高血压的饮食管理上。文献中充斥着证据表明素食和低钠饮食模式与较低的血压水平相关。这意味着如果许多人能够采用素食和低盐饮食习惯，高血压的患病率将显著降低。然而，大多数人觉得“无盐”素食淡而无味且难以接受。因此，我们需要确定直接影响血压的常量和微量营养素（除钠之外）。多项研究表明，富含纤维、钙、钾和镁的饮食模式有利于控制血压。本综述着重介绍了其中一些研究结果，并强调需要进行大型临床试验，通过将上述常量和微量营养素纳入社会文化上可接受且美味可口的菜单来测试降低血压的饮食模式，尤其是在非裔美国人中。
