一项关于饮食模式对血压影响的临床试验。DASH 协作研究小组。

A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group.

作者信息

Appel L J, Moore T J, Obarzanek E, Vollmer W M, Svetkey L P, Sacks F M, Bray G A, Vogt T M, Cutler J A, Windhauser M M, Lin P H, Karanja N

机构信息

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.

出版信息

N Engl J Med. 1997 Apr 17;336(16):1117-24. doi: 10.1056/NEJM199704173361601.

DOI:10.1056/NEJM199704173361601

PMID:9099655

Abstract

BACKGROUND

It is known that obesity, sodium intake, and alcohol consumption factors influence blood pressure. In this clinical trial, Dietary Approaches to Stop Hypertension, we assessed the effects of dietary patterns on blood pressure.

METHODS

We enrolled 459 adults with systolic blood pressures of less than 160 mm Hg and diastolic blood pressures of 80 to 95 mm Hg. For three weeks, the subjects were fed a control diet that was low in fruits, vegetables, and dairy products, with a fat content typical of the average diet in the United States. They were then randomly assigned to receive for eight weeks the control diet, a diet rich in fruits and vegetables, or a "combination" diet rich in fruits, vegetables, and low-fat dairy products and with reduced saturated and total fat. Sodium intake and body weight were maintained at constant levels.

RESULTS

At base line, the mean (+/-SD) systolic and diastolic blood pressures were 131.3+/-10.8 mm Hg and 84.7+/-4.7 mm Hg, respectively. The combination diet reduced systolic and diastolic blood pressure by 5.5 and 3.0 mm Hg more, respectively, than the control diet (P<0.001 for each); the fruits-and-vegetables diet reduced systolic blood pressure by 2.8 mm Hg more (P<0.001) and diastolic blood pressure by 1.1 mm Hg more than the control diet (P=0.07). Among the 133 subjects with hypertension (systolic pressure, > or =140 mm Hg; diastolic pressure, > or =90 mm Hg; or both), the combination diet reduced systolic and diastolic blood pressure by 11.4 and 5.5 mm Hg more, respectively, than the control diet (P<0.001 for each); among the 326 subjects without hypertension, the corresponding reductions were 3.5 mm Hg (P<0.001) and 2.1 mm Hg (P=0.003).

CONCLUSIONS

A diet rich in fruits, vegetables, and low-fat dairy foods and with reduced saturated and total fat can substantially lower blood pressure. This diet offers an additional nutritional approach to preventing and treating hypertension.

摘要

背景

已知肥胖、钠摄入和饮酒等因素会影响血压。在这项名为“终止高血压膳食方法（Dietary Approaches to Stop Hypertension, DASH）”的临床试验中，我们评估了饮食模式对血压的影响。

方法

我们招募了459名收缩压低于160 mmHg且舒张压在80至95 mmHg之间的成年人。在三周时间里，让这些受试者食用一种对照饮食，该饮食中水果、蔬菜和乳制品含量较低，脂肪含量为美国普通饮食的典型水平。然后将他们随机分配，使其在接下来的八周里分别接受对照饮食、富含水果和蔬菜的饮食，或富含水果、蔬菜和低脂乳制品且饱和脂肪和总脂肪含量降低的“组合”饮食。钠摄入量和体重维持在恒定水平。

结果

在基线时，平均（±标准差）收缩压和舒张压分别为131.3±10.8 mmHg和84.7±4.7 mmHg。与对照饮食相比，组合饮食使收缩压和舒张压分别降低了5.5 mmHg和3.0 mmHg以上（每项P<0.001）；水果和蔬菜饮食使收缩压降低了2.8 mmHg以上（P<0.001），舒张压比对照饮食降低了1.1 mmHg（P = 0.07）。在133名高血压患者（收缩压≥140 mmHg；舒张压≥90 mmHg；或两者兼有）中，组合饮食使收缩压和舒张压分别比对照饮食降低了11.4 mmHg和5.5 mmHg以上（每项P<0.001）；在326名非高血压患者中，相应的降低幅度分别为3.5 mmHg（P<0.001）和2.1 mmHg（P = 0.003）。