Effects of the DASH diet and losartan on serum urate among adults with hypertension: Results of a randomized trial.
Effects of the DASH diet and losartan on serum urate among adults with hypertension: Results of a randomized trial.
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DOI：
10.1111/jch.14721
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发表时间：
2023-10
影响因子：
2.8
通讯作者：
Juraschek, Stephen P.
中科院分区：
文献类型：
--
作者：
Castilla-Ojo, Noelle;Turkson-Ocran, Ruth-Alma;Conlin, Paul R.;Appel, Lawrence J.;Miller III, Edgar R.;Juraschek, Stephen P.
血清尿酸是高血压和痛风的危险因素。DASH饮食和氯沙坦单独降低血压(BP)；然而，它们对血尿酸的影响尚未得到充分研究。我们对DASH-氯沙坦试验进行了事后分析，将患有高血压的参与者随机分为DASH饮食或标准美国饮食(对照)，并以交叉方式加入为期4周的氯沙坦或安慰剂。在基线和每4周后测定血尿酸。饮食的设计是为了保持体重恒定。我们使用广义估计方程检验了DASH(与对照组相比)和/或氯沙坦(与安慰剂相比)对血尿酸的影响，总体上以及基线血尿酸≥为6 mg/dL的患者。55例受试者(平均年龄52岁，女性58%，黑人)，平均(±SD)基线动态收缩压/舒张压为146±12/91±9，平均(±SD)血尿酸为5.2±1.2 mg/dL。DASH饮食总体上没有显著降低尿酸水平(平均差值−为0.05mgdL；95%可信区间：−0.39，0.28)，但降低了基线高尿酸血症参与者的尿酸水平(−0.33 mg/dL；95%可信区间：−0.87，0.21；P-交互作用=0.007)。氯沙坦显著降低血尿酸(−0.23 mg/dL；95%CI：−0.40，−0.05)，对60岁及60岁成人血尿酸的影响大于≥60岁(−0.33 mg/dL对0.16 mg/dL，P交互作用=0.003)。总而言之，DASH饮食显著降低了尿酸水平较高的参与者的血尿酸，而氯沙坦显著降低了血尿酸，尤其是在年轻人中。未来的研究应该检查这些干预措施对高尿酸血症或痛风患者的影响。
Serum urate is a risk factor for hypertension and gout. The DASH diet and losartan independently lower blood pressure (BP); however, their effects on serum urate are understudied. We performed a post‐hoc analysis of the DASH‐losartan trial, which randomized participants with hypertension in parallel fashion to the DASH diet or a standard American diet (control) and in crossover fashion to 4‐week losartan or placebo. Serum urate was measured at baseline and after each 4‐week period. Diets were designed to maintain weight constant. We examined the effects of DASH (vs control) and/or losartan (vs placebo) on serum urate, overall and among those with baseline serum urate ≥6 mg/dL, using generalized estimating equations. Of 55 participants (mean age 52 years, 58% women, 64% Black), mean (±SD) baseline ambulatory SBP/DBP was 146±12/91±9 and mean (±SD) serum urate was 5.2±1.2 mg/dL. The DASH diet did not significantly reduce urate levels overall (mean difference −0.05 mg/dL; 95%CI: −0.39, 0.28), but did decrease levels among participants with baseline hyperuricemia (−0.33 mg/dL; 95%CI: −0.87, 0.21; P‐interaction=0.007 across hyperuricemia groups). Losartan significantly decreased serum urate (−0.23 mg/dL; 95%CI: −0.40, −0.05) with greater effects on serum urate among adults <60 years old versus adults ≥60 years old (−0.33 mg/dL vs 0.16 mg/dL, P interaction = 0.003). In summary, the DASH diet significantly decreased serum urate among participants with higher urate at baseline, while losartan significantly reduced serum urate, especially among younger adults. Future research should examine the effects of these interventions in patients with hyperuricemia or gout.
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DOI：
10.1124/jpet.106.112755
发表时间：
2007-01-01
影响因子：
3.5
作者：
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