Dietary Approaches to Stop Hypertension Dietary Intervention Improves Blood Pressure and Vascular Health in Youth With Elevated Blood Pressure.
Dietary Approaches to Stop Hypertension Dietary Intervention Improves Blood Pressure and Vascular Health in Youth With Elevated Blood Pressure.
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DOI：
10.1161/hypertensionaha.120.16156
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Urbina EM
中科院分区：
文献类型：
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作者：
Couch SC;Saelens BE;Khoury PR;Dart KB;Hinn K;Mitsnefes MM;Daniels SR;Urbina EM
这项随机对照试验评估了为期 6 个月的以预防高血压饮食方法 (DASH) 为重点的行为营养干预措施的干预后和 18 个月随访效果，该干预措施在临床上启动，随后通过电话和邮件联系，对高血压青少年的血压和内皮功能产生影响。对在医院诊所接受治疗的新诊断血压升高或 1 期高血压的 11-18 岁青少年 (n=159) 进行随机分组。 DASH 参与者收到了一份带回家的手册，以及 2 次基线时的面对面咨询课程以及 3 个月与营养师就 DASH 饮食进行的咨询、6 个月一次的邮件以及每周 8 次和每两周 7 次的电话，重点关注促进 DASH 依从性的行为策略。常规护理参与者根据国家高血压教育计划制定的儿科指南接受营养师的营养咨询。干预前后以及 18 个月随访时测量的结果包括血压变化、肱动脉血流介导的扩张变化以及基于 3 天饮食回忆的 DASH 评分变化。与常规护理相比，接受 DASH 治疗的青少年从基线到治疗后的收缩压（−2.7 mm Hg，p=.03，−0.3 z 得分，p=.03）、血流介导扩张（2.5%，p=.05）和 DASH 评分（13.3 分，p<.0001）有更大改善，血流介导扩张（3.1%， p=.03）和 DASH 评分（7.4 分，p=.01）至 18 个月。事实证明，DASH 干预对于高血压和高血压青少年的初始收缩压改善以及内皮功能和饮食质量的长期改善比常规护理更有效。网址：http://www.clinicaltrials.gov。标识符：NCT00585832
This randomized control trial assessed the post-intervention and 18-month follow-up effects of a 6-month Dietary Approaches to Stop Hypertension (DASH)-focused behavioral nutrition intervention, initiated in clinic with subsequent telephone and mail contact, on blood pressure and endothelial function in adolescents with elevated blood pressure. Adolescents (n=159) 11-18 years of age with newly diagnosed elevated blood pressure or stage 1 hypertension treated at a hospital-based clinic were randomized. DASH participants received a take-home manual plus 2 face-to-face counseling sessions at baseline and 3-months with a dietitian regarding the DASH diet, 6 monthly mailings, and 8 weekly and then 7 biweekly telephone calls focused on behavioral strategies to promote DASH adherence. Routine care participants received nutrition counseling with a dietitian consistent with pediatric guidelines established by the National High Blood Pressure Education Program. Outcomes, measured pre and post-intervention and at 18-months follow-up, included change in blood pressure, change in brachial artery flow mediated dilation, and change in DASH score based on 3-day diet recalls. Adolescents in DASH versus routine care had a greater improvement in systolic blood pressure (−2.7 mm Hg, p=.03, −0.3 z-score, p=.03), flow mediated dilation (2.5%, p=.05), and DASH score (13.3 points, p<.0001) from baseline to post-treatment and a greater improvement in flow mediated dilation (3.1%, p=.03) and DASH score (7.4 points, p=.01) to 18-months. The DASH intervention proved more effective than routine care in initial systolic blood pressure improvement and longer term improvement in endothelial function and diet quality in adolescents with elevated blood pressure and hypertension. URL: http://www.clinicialtrials.gov. Identifier: NCT00585832