DIETARY INTERVENTIONS IN THE ELDERLY DIET TRIAL

相当一部分老年人（大约30-40%）正在接受 治疗血压（BP）药物的疗效BP药物 舒张压或舒张压/收缩压合并的老年患者的治疗 高血压已被充分证实，但毫无疑问，这种治疗可以 对生活质量和生物化学特征产生不利影响。 有一个 令人信服的理由，以（1）确定药物的比例，以及- 可维持控制的老年高血压患者（长期; >30个月） 血压药物停药后血压正常，和（2） 确定非药物治疗是否可以显著增加 取得成功的比例。 900例65-80岁SBP受试者（4家中心各225例） <160且DBP <90 mmhg，同时接受一种BP药物治疗将入组 在一项测试减肥和限钠效果的试验中， （单独和组合）在维持正常血压状态以下 停用抗高血压药物。 超重六百磅 参与者将被随机分配到减肥，限钠， 结合减肥和限钠，或注意力控制。 三个... 100名非超重的参与者将被随机分配到一个钠 限制或注意力控制组。 关注组将 从事一系列与BP无关的健康接触，旨在控制 群体接触的非特异性影响。 停用抗高血压药 将在干预6周后尝试药物治疗。 的 主要试验终点将是复发性降压药物的需求 疗法 这项研究的意义在于，我们的发现可能 确定一种非药物方法，提供一种安全和良好的， 耐受的方法，其中停止降压药物治疗， 目前约有1500万65岁以上的人 用BP药物治疗。 此外，我们的研究将确定 老年高血压患者的比例可以维持在 血压正常状态，在停药后不进行任何干预 BP药物

A substantial proportion (probably 30-40%) of elderly persons are being treated with blood pressure (BP) medications the efficacy of BP drug therapy in older patients with diastolic or combined diastolic/systolic hypertension is well proven but there is little doubt that such therapy can adversely effect quality of life and the biochemical profile. There is a compelling rationale to (1) identify what proportion of medicated, well- controlled elderly hypertensives can be maintained (long-term; >30 months) in the normotensive state following withdrawal of BP medications, and (2) determine whether non-pharmacologic therapy can significantly increase the proportion with a successful outcome. Nine-hundred subjects (225 in each of four centers) 65-80 yrs, with a SBP <160 and DBP <90 mmhg, while receiving one BP medication will be enrolled in a trial to test the efficacy of weight loss and sodium restriction (alone and combined) in maintaining the normotensive state following withdrawal of antihypertensive medications. Six-hundred overweight participants will be randomly assigned to weight loss, sodium restriction, combined weight loss and sodium restriction, or attention control. Three- hundred non-overweight participants will be randomly assigned to a sodium restriction or attention control group. The attention groups will be engaged in a series of non-BP related health encounters designed to control for non-specific effects of group contacts. Withdrawal of antihypertensive medications will be attempted following 6 weeks of intervention. The primary trial endpoint will be the need for recurrent antihypertensive drug therapy. The significance of the proposed study is that our findings may identify a non-pharmacologic approach which provides a safe and well- tolerated method by which to discontinue antihypertensive drug therapy in the approximately 15 million persons >65 years who are currently being treated with BP medications. In addition, our study will identify the proportion of elderly hypertensives who can be maintained in the normotensive state without any intervention following withdrawal of their BP medications.