Degree of concordance with DASH diet guidelines and incidence of hypertension and fatal cardiovascular disease
Degree of concordance with DASH diet guidelines and incidence of hypertension and fatal cardiovascular disease
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DOI：
10.1016/j.amjhyper.2006.09.003
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发表时间：
2007-03-01
影响因子：
3.2
通讯作者：
Harnack, Lisa J.
中科院分区：
文献类型：
--
作者：
Folsom, Aaron R.;Parker, Emily D.;Harnack, Lisa J.
背景：预防和治疗高血压的指南提倡采用终止高血压膳食疗法（DASH）饮食。
方法：我们研究了在20993名初始年龄为55 - 69岁的女性中，与DASH饮食的契合度越高是否与高血压（自我报告）发病率降低以及心血管疾病死亡率降低相关。我们利用1986年的食物频率数据创建了一个DASH饮食契合度评分，并对这些女性进行随访直至2002年观察相关事件。
结果：没有女性与DASH饮食完全契合。在对年龄和能量摄入进行调整后，高血压发病率与DASH饮食契合度呈负相关，五分位数的风险比分别为1.0、0.91、0.95、0.99和0.87（趋势P = 0.02）。更好的DASH饮食契合度与冠心病、中风和所有心血管疾病（CVD）死亡率之间也存在负相关，但并非单调相关。然而，在对其他风险因素进行调整后，几乎没有证据表明任何终点与DASH饮食评分相关。
结论：我们的研究结果表明，在该队列中，与DASH指南的契合度更高与高血压或心血管疾病死亡率之间没有独立的长期关联。这意味着可能需要像在DASH试验中那样达到非常高的契合度，才能实现DASH饮食的任何益处。
Background: Guidelines to prevent and treat hypertension advocate the Dietary Approaches to Stop Hypertension (DASH) diet.Methods: We studied whether a greater concordance with the DASH diet is associated with reduced incidence of hypertension (self-reported) and mortality from cardiovascular disease in 20,993 women initially aged 55 to 69 years. We created a DASH diet concordance score using food frequency data in 1986 and followed the women for events through 2002.Results: No woman had perfect concordance with the DASH diet. Adjusted for age and energy intake, incidence of hypertension was inversely associated with the degree of concordance with the DASH diet, with hazard ratios across quintiles of 1.0, 0.91, 0.95, 0.99, and 0.87 (P trend =.02). There also were inverse, but not monotonic, associations between better DASH diet concordance and mortality from coronary heart disease, stroke, and all cardiovascular disease (CVD). However, after adjustment for other risk factors, there was little evidence that any end point was associated with the DASH diet score.Conclusions: Our results suggest that greater concordance with DASH guidelines did not have an independent long-term association with hypertension or cardiovascular mortality in this cohort. This implies that very high concordance, as achieved in the DASH trials, may be necessary to achieve any benefits of the DASH diet.