Randomized clinical trials of weight reduction in nonhypertensive persons
Randomized clinical trials of weight reduction in nonhypertensive persons
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DOI：
10.1016/1047-2797(91)90046-f
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发表时间：
1991-01-01
影响因子：
5.6
通讯作者：
Cutler, Jeffrey A.
中科院分区：
文献类型：
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作者：
Cutler, Jeffrey A.
自1987年以来，有四项随机对照临床试验，872名非高血压受试者产生了减肥干预的结果，包括减少热量摄入和/或增加支出，对血压（BP）的影响。高血压预防试验在36个月内保持了3.5公斤的净体重减轻，仅减少摄入量。与对照组相比，该方案使血压降低了2.411.8 mm Hg（收缩压/舒张压），但与减少钠摄入量相结合时，体重减轻和血压变化都较小。斯坦福大学的一项试验在12个月内通过节食和锻炼分别减轻了7.4和5.1公斤的体重。对门诊血压的影响在1.5至3.0 mm Hg范围内，干预方法无差异。在密歇根大学进行的唯一一项儿童试验发现，在20周内限制热量摄入对体重减轻（约7公斤）和血压的影响相似，无论是否包括运动计划;然而，后者确实导致体脂百分比，心率和血清胰岛素水平的更大降低。高血压一级预防试验测试了多因素干预，包括减轻体重（平均2.7 kg），钠和酒精摄入量以及增加体力活动。在5年的时间里，门诊血压降低了2.0/1.9毫米汞柱，高血压的发病率降低了52%。它的结论是，体重减轻，但实现，降低血压超重非高血压的人，并可能有助于大大降低高血压的发病率。增加体力活动和减少钠摄入量是否对体重减轻有独立的作用尚不清楚。
Since 1987, four randomized controlled clinical trials with 872 nonhypertensive subjects have produced results on weight-reducing interventions, involving decreased caloric intake and/or increased expenditure, for effects on blood pressure (BP). The Hypertension Prevention Trial maintained a 3.5-kg net weight loss through 36 months with intake reduction alone. This program decreased BP by 2.411.8 mm Hg (systolic/diastolic) compared to controls, but both weight loss and blood pressure changes were smaller when combined with decreased sodium intake. A Stanford University trial achieved weight losses of 7.4 and 5.1 kg over 12 months with diet and exercise, respectively. Effects on clinic BP were in the range of 1.5 to 3.0 mm Hg and did not differ by intervention approach. The sole trial in children, conducted at University of Michigan, found similar weight loss (about 7 kg) and BP effects from limiting caloric intake over 20 weeks, regardless of inclusion of an exercise program; the latter did, however, result in greater reductions in percent body fat, heart rate, and serum insulin levels. The Primary Prevention of Hypertension trial tested a multifactor intervention including reductions in weight (mean, 2.7 kg), sodium and alcohol intake, and increased physical activity. During a 5-year period, clinic BP was reduced by 2.0/1.9 mm Hg, and the incidence of hypertension, by 52%. It is concluded that weight loss, however achieved, lowers BP in overweight nonhypertensive persons, and probably can contribute substantially to reducing the incidence of hypertension. Whether there are independent effects additive to weight loss from increasing physical activity and reducing sodium intake remains unknown.