Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-Month results of a randomized trial
Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-Month results of a randomized trial
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DOI：
10.7326/0003-4819-144-7-200604040-00007
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发表时间：
2006-04-04
影响因子：
39.2
通讯作者：
Appel, LJ
中科院分区：
文献类型：
--
作者：
Elmer, PJ;Obarzanek, E;Appel, LJ
背景资料：PREMIER试验的主要6个月结果显示，综合行为干预方案改善了生活方式行为并降低了血压。目的：比较2种多组分行为干预与仅建议对高血压状态、生活方式改变和血压的18个月效果。设计：2000年1月至2002年11月进行的多中心、3组、随机试验。4个临床中心和一个协调中心。患者：810名患有高血压前期或1期高血压的成年志愿者（收缩压，120至159 mm Hg;舒张压，80至95 mm Hg）。干预措施：实施长期建议的多组分行为干预措施（“已建立”）;一种多成分行为干预，实施已建立的建议加上停止高血压饮食方法（DASH）饮食（“建立加DASH”）;和建议。测量：生活方式变量和血压状态。18个月随访血压测量为94%。结果：与仅建议相比，两种行为干预均显著降低了体重、脂肪摄入量和钠摄入量。已建立的加DASH干预也在统计学上显着增加了水果，蔬菜，乳制品，纤维和矿物质的摄入量。相对于仅建议组，18个月时高血压的比值比为0.83（95% CI，0.67至1.04），建立组和0.77（CI，0.62至0.97），建立+DASH组。虽然在18个月的绝对血压下降是更大的参与者在建立和建立加DASH组比的建议只有group.Limitations，差异没有统计学意义：排除标准和志愿者的性质，这一队列可能会限制普遍性。虽然血压是一个公认的心血管疾病的危险因素，作者没有能够评估干预对临床心血管事件的影响，在这有限的时间，并与此样本size.Conclusions：在18个月以上，高血压前期和1期高血压的人可以维持多种生活方式的改变，提高控制血压，并可以降低慢性疾病的风险。
Background: The main 6-month results from the PREMIER trial showed that comprehensive behavioral intervention programs improve lifestyle behaviors and lower blood pressure.Objective: To compare the 18-month effects of 2 multicomponent behavioral interventions versus advice only on hypertension status, lifestyle changes, and blood pressure.Design: Multicenter, 3-arm, randomized trial conducted from January 2000 through November 2002.Setting: 4 clinical centers and a coordinating center.Patients: 810 adult volunteers with prehypertension or stage 1 hypertension (systolic blood pressure, 120 to 159 mm Hg; diastolic blood pressure, 80 to 95 mm Hg).Interventions: A multicomponent behavioral intervention that implemented long-established recommendations ("established"); a multicomponent behavioral intervention that implemented the established recommendations plus the Dietary Approaches to Stop Hypertension (DASH) diet ("established plus DASH"); and advice only.Measurements: Lifestyle variables and blood pressure status. Follow-up for blood pressure measurement at 18 months was 94%.Results: Compared with advice only, both behavioral interventions statistically significantly reduced weight, fat intake, and sodium intake. The established plus DASH intervention also statistically significantly increased fruit, vegetable, dairy, fiber, and mineral intakes. Relative to the advice only group, the odds ratios for hypertension at 18 months were 0.83 (95% Cl, 0.67 to 1.04) for the established group and 0.77 (Cl, 0.62 to 0.97) for the established plus DASH group. Although reductions in absolute blood pressure at 18 months were greater for participants in the established and the established plus DASH groups than for the advice only group, the differences were not statistically significant.Limitations: The exclusion criteria and the volunteer nature of this cohort may limit generalizability. Although blood pressure is a well-accepted risk factor for cardiovascular disease, the authors were not able to assess intervention effects on clinical cardiovascular events in this limited time and with this sample size.Conclusions: Over 18 months, persons with prehypertension and stage 1 hypertension can sustain multiple lifestyle modifications that improve control of blood pressure and could reduce the risk for chronic disease.