Effects of comprehensive lifestyle modification on blood pressure - Control main results of the PREMIER clinical trial
Effects of comprehensive lifestyle modification on blood pressure - Control main results of the PREMIER clinical trial
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DOI：
10.1001/jama.289.16.2083
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发表时间：
2003-04-23
影响因子：
120.7
通讯作者：
Young, DR
中科院分区：
文献类型：
--
作者：
Appel, LJ;Champagne, CM;Young, DR
背景减肥、减少钠、增加体力活动和限制酒精摄入是降低血压（BP）的既定建议。停止高血压的饮食方法（DASH）饮食也能降低血压。到目前为止，还没有试验评估同时实施这些生活方式recommendations.Objective的影响，以确定对血压的影响2多组分，行为干预。设计，设置和参与者随机试验，在4个临床中心招募（2000年1月至2001年6月）（平均[SD]年龄，50 [8.9]岁; 62%为女性; 34%非洲裔美国人），血压高于最佳水平，包括1期高血压（收缩压120-159 mm Hg，舒张压80-95 mm Hg），并且没有服用抗高血压药物。干预参与者被随机分为3个干预组：（1）“已建立”，实施已建立建议的行为干预（n=268）;（2）“已建立+DASH“，也实施DASH饮食（n=269）;（3）单纯咨询对照组（n=273）主要结果测量血压测量和6个月时的高血压状态。结果两种行为干预都显著降低了体重，提高了身体素质，降低了钠的摄入量已建立的DASH干预还增加了水果，蔬菜和乳制品的摄入量。在各组中，血压和高血压状态的梯度很明显。减去仅建议的变化后，收缩压平均净下降3.7 mm Hg（P
Context Weight loss, sodium reduction, increased physical activity, and limited alcohol intake are established recommendations that reduce blood pressure (BP). The Dietary Approaches to Stop Hypertension (DASH) diet also lowers BP. To date, no trial has evaluated the effects of simultaneously implementing these lifestyle recommendations.Objective To determine the effect on BP of 2 multicomponent, behavioral interventions.Design, Setting, and Participants Randomized trial with enrollment at 4 clinical centers (January 2000-June 2001) among 810 adults (mean [SD] age, 50 [8.9] years; 62% women; 34% African American) with above-optimal BP, including stage 1 hypertension (120-159 mm Hg systolic and 80-95 mm Hg diastolic), and who were not taking anti hypertensive medications.Intervention Participants were randomized to one of 3 intervention groups: (1) "established," a behavioral intervention that implemented established recommendations (n=268); (2) "established plus DASH, "which also implemented the DASH diet (n=269); and (3) an "advice only" comparison group (n=273).Main Outcome Measures Blood pressure measurement and hypertension status at 6 months.Results Both behavioral interventions significantly reduced weight, improved fitness, and lowered sodium intake. The established plus DASH intervention also increased fruit, vegetable, and dairy intake. Across the groups, gradients in BP and hypertensive status were evident. After subtracting change in advice only, the mean net reduction in systolic BP was 3.7 mm Hg (P