Svetkey L P, Simons-Morton D, Vollmer W M, Appel L J, Conlin P R, Ryan D H, Ard J, Kennedy B M
Duke University Medical Center, Department of Medicine, Durham, NC, USA.
Arch Intern Med. 1999 Feb 8;159(3):285-93. doi: 10.1001/archinte.159.3.285.
To determine the effects of dietary patterns on blood pressure in subgroups.
Dietary Approaches to Stop Hypertension (DASH) was a randomized controlled feeding study conducted at 4 academic medical centers. Participants were 459 adults with untreated systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg. For 3 weeks, participants were fed a "control" diet. They were then randomized to 8 weeks of (1) control diet; (2) a diet rich in fruits and vegetables; or (3) a combination diet rich in fruits, vegetables, and low-fat dairy foods, and reduced in saturated fat, total fat, and cholesterol (the DASH combination diet). Weight and salt intake were held constant. Change in diastolic blood pressure was the primary outcome variable, and systolic blood pressure a secondary outcome. Subgroups analyzed included race, sex, age, body mass index, years of education, income, physical activity, alcohol intake, and hypertension status.
The combination diet significantly lowered systolic blood pressure in all subgroups (P<.008), and significantly lowered diastolic blood pressure (P<.01) in all but 2 subgroups. The fruits-and-vegetables diet also reduced blood pressure in the same subgroups, but to a lesser extent. The combination diet lowered systolic blood pressure significantly more in African Americans (6.8 mm Hg) than in whites (3.0 mm Hg), and in hypertensive subjects (11.4 mm Hg) than in nonhypertensive subjects (3.4 mm Hg) (P<.05 for both interactions).
The DASH combination diet, without sodium reduction or weight loss, significantly lowered blood pressure in virtually all subgroups examined, and was particularly effective in African Americans and those with hypertension. The DASH combination diet may be an effective strategy for preventing and treating hypertension in a broad cross section of the population, including segments of the population at highest risk for blood pressure-related cardiovascular disease.
确定不同饮食模式对亚组人群血压的影响。
“终止高血压膳食疗法（DASH）”是一项在4个学术医学中心开展的随机对照喂养研究。参与者为459名未接受治疗的成年人，其收缩压低于160毫米汞柱，舒张压在80至95毫米汞柱之间。在3周时间里，为参与者提供“对照”饮食。随后，他们被随机分配接受为期8周的以下饮食：（1）对照饮食；（2）富含水果和蔬菜的饮食；或（3）富含水果、蔬菜和低脂乳制品且饱和脂肪、总脂肪和胆固醇含量降低的组合饮食（DASH组合饮食）。体重和盐摄入量保持恒定。舒张压的变化是主要结局变量，收缩压是次要结局。分析的亚组包括种族、性别、年龄、体重指数、受教育年限、收入、身体活动、酒精摄入量和高血压状态。
组合饮食在所有亚组中均显著降低了收缩压（P<0.008），除2个亚组外，在其他所有亚组中均显著降低了舒张压（P<0.01）。水果和蔬菜饮食在相同亚组中也降低了血压，但程度较小。组合饮食使非裔美国人的收缩压降低幅度（6.8毫米汞柱）显著大于白人（3.0毫米汞柱），使高血压患者的收缩压降低幅度（11.4毫米汞柱）显著大于非高血压患者（3.4毫米汞柱）（两种相互作用的P值均<0.0５）。
DASH组合饮食在不减少钠摄入或不减轻体重的情况下，几乎在所有检测的亚组中均显著降低了血压，对非裔美国人和高血压患者尤其有效。DASH组合饮食可能是预防和治疗广大人群高血压的有效策略，包括血压相关心血管疾病风险最高的人群。
