DESIRABLE DIET FOR BLOOD PRESSURE REDUCTION--PREVENTIVE CARDIOLOGY

点击翻译按钮获取中文摘要

High blood pressure (BP) or hypertension (HTN) is a major cause of morbidity and mortality in the U.S., and more so in the African-American population. Even though there have been indications since as early as the beginning of the century that BP might be influenced by dietary factors, it has remained generally ignored and the main stay of HTN treatment has been the use of pharmacological antihypertensives. However, attention is now being focused on dietary management of HTN because of the high cost of drug therapy, the realization that some antihypertensives are associated with adverse reactions, and the fact that hypertensives treated only by pharmacological means continue to be at risk for progression to major and debilitating coronary artery disease. The literature is replete with evidence that vegetarian and low sodium dietary patterns are associated with lower BP levels. Many investigators have tried to identify the dietary factors responsible for reducing BP, but the results have been inconsistent. The purpose of this pilot study is to try to identify palatable and socioculturally acceptable dietary patterns enriched with nutrients believed to reduce BP, since these factors are not clearly known and not many people would enjoy unsalted or vegetarian diets. Thirty-two African Americans with high normal BP levels or Stage I-HTN will be randomized, after a baseline period into 1 control and 3 study groups. Those in the control group will receive a "typical" American diet, and those in each study group will receive one of the following formulated dietary patters 3 times a day for 12 weeks: 1) A modified Step-One National Cholesterol Education Program (NCEP) + high potassium (K), calcium (Ca), magnesium (mg), and fiber; 2) a Step- One NCEP; and 3) a modified "typical" American diet + high K, Ca, Mg, and fiber. All foods will be prepared in a diet kitchen. Arterial BP levels, obtained during the study periods, will be compared to baseline control levels, and changes in BP will be correlated with the dietary patterns used. It is anticipated that one or more of the formulated dietary patterns will be effective in reducing BP and can be used in HTN management as either an alternative, or complementary, to drug therapy.