INTL POPULATION STUDY ON MACRONUTRIENTS AND BP INTERMAP

InterMAP是基本的流行病学调查，旨在帮助澄清 关于饮食因素作用的悬而未决的问题，特别是 常量营养素在不良血压(BP)水平病因中的作用 在美国大多数中老年人中很流行。 人口。一个特别的焦点--在这个整体的背景下 目的是帮助阐明这些饮食因素在 造成更不利的BP模式的原因是受教育程度低 人口状况，例如在美国，受教育程度较低的非裔美国人 还有怀特。Intermap的目标是在这些重要的方面取得重大进展 基于其设计的问题，模仿了经过测试的Intersalt模型： 大样本人数为5200人(2600名男性和2600名女性)，年龄在40-59岁之间 来自20个不同种族、SES和饮食的不同人群样本 4个国家(中国、日本、英国、美国)的习惯(每样本260人)。 成本效益由非美国中心的主要成本分担来确保，因此 NHLBI的成本比进行这种规模的研究要少得多 仅在美国。具体目标包括阐明对BP的影响 蛋白质、脂肪、碳水化合物的数量和类型，还有氨基酸、钙、 镁、抗氧化剂、纤维、咖啡因。待检验的主要假设，包括 控制BMI、饮酒、钠、钾、年龄、性别等混杂因素； 饮食蛋白质与血压呈负相关； 教育和BP在很大程度上是由与教育相关的 饮食中蛋白质摄入量的差异；与高血压有直接关系 膳食SFA、胆固醇、关键分数、淀粉；呈负相关 随机选择的PFA和P.S.参与者将提供2个计时 24小时尿液收集以评估钠、钾、肌酐、尿素和 完成四次24小时饮食召回。每个BP测量两次 共4次就诊。这项研究将由两个协调机构协调进行 中心-西北大学、芝加哥和伦敦卫生学院 和热带医学。尿液测定将在中心进行 比利时鲁汶的实验室。24小时饮食召回将被转换 在每个国家使用最新的、广泛的、高度的- 高质量、维护良好的国家营养成分数据库 食品和食谱，具有国际研究范围的标准化、高质量 控制和支持这项工作以及相关的地方和国家任务。数据 将进行分析以检验假设并探索营养与血压的关系。 在伦敦协调中心。关于多重关系的发现 饮食因素对血压的影响将被用来估计对血压的有利影响 按人口分类的营养状况的多重改善。反过来，这又应该是 帮助提出饮食建议，以实现初级保健的目标 预防高血压，并将血压分布向下移动以避免 与当前水平相关的超额风险一般高于最优水平。

INTERMAP is basic epidemiologic investigation designed to help clarify unanswered questions on the role of dietary factors, particularly macronutrients, in the etiology of unfavorable blood pressure (BP) levels prevailing for a majority of middle-aged and older individuals in the U.S. population. A particular focus -- within the context of this overall objective -- is to help elucidate the role of these dietary factors in accounting for the even more adverse BP patterns of less educated population state, e.g., in the U.S. both less educated African-Americans and Whites. INTERMAP aims to achieve a major advance on these important issues, based on its design, patterned after the tested INTERSALT model: large sample size of 5,200 persons (2,600 men and 2,600 women), ages 40-59 from 20 diverse population samples of varied ethnicity, SES, and dietary habits in 4 countries (China, Japan, U.K., U.S.) (260 persons per sample). Cost effectiveness is assured by major cost-sharing by non-U.S. centers, so that costs for NHLBI are much less than for research of this scope done solely in the U.S. Specific aims involve elucidating influences on BP of amount and type of protein, lipids, carbohydrates, also amino acids, Ca, Mg, antioxidants, fiber, caffeine. Primary hypotheses to be tested, with control for BMI, intake of alcohol, Na, K, age, sex, other confounders are; dietary protein is inversely related to BP; inverse relations between education and BP are significantly accounted for by education-correlated differences in dietary protein intake; there is a direct relation to BP of dietary SFA, cholesterol, keys score, starch; there is an inverse relation of PFA and of P.S. Participants, randomly selected, are to provide 2 timed 24-hr urine collections for assessment of Na, K, creatinine, urea, and are to complete four 24-hr dietary recalls. BP is to be measured twice at each of 4 clinic visits. The study is to be coordinated by two Coordinating Centers -- Northwestern University, Chicago and london School of Hygiene and Tropical Medicine. Urinary determinations are to be made at a Central Laboratory in Leuven, Belgium. 24-hr dietary recalls are to be converted into nutrients with use in each country of an up-to-date, extensive, high- quality, well-maintained national data base on nutrient composition of foods and recipes, with international study-wide standardization, quality control, and support for this and related local and national tasks. Data analyses o test hypotheses and explore nutrient-BP relations are to be done at the london Coordinating Center. Findings on relations of multiple dietary factors to BP are to be used to estimate favorable impact on BP of multiple improvements in nutrition by populations. This, in turn, should aid in making dietary recommendations toward achieving the goal of primary prevention of hypertension, and shifting BP distributions downward to avoid excess risk associated with present levels generally above optimal.