OBSERVATIONAL COHORT STUDY OF SODIUM, WEIGHT AND CVD

钠的减少和体重的减轻导致血压下降。在高血压患者中，血压降低可降低心肌梗死、中风和心血管死亡的风险。尽管如此，人们还是对低钠摄入量或体重变化大的个体心血管事件数量增加表示担忧。高血压预防试验（TOHP）的前瞻性观察随访将包括来自10个临床中心的4507名幸存参与者的心血管事件，这些参与者参与了TOHP的I期和II期。第一阶段是一项随机试验，对2182名参与者进行为期18个月的随访，研究包括减钠和减肥在内的非药物干预对血压的影响。第二阶段研究采用随机2X2析因设计，在36个月的时间里，研究了减钠和减肥对血压的影响，共有2382名参与者。在TOHP的第一和第二阶段的随访中，仔细地获得了所有参与者的体重和钠排泄的一些测量。提出的前瞻性观察性随访将专门检查这些值，重点是钠排泄量的平均水平和体重变化是否可以预测后来的心血管疾病。后续工作将由预防医学部通过邮件集中进行，该司是第一和第二阶段的协调中心，在通过邮件进行这种大规模研究方面非常成功。试验结束后心血管事件的信息将收集到2003年6月，从第一阶段结束到第二阶段结束，平均随访时间约为14年。该队列研究提供了一个独特的资源来研究正常人群限制盐摄入和体重变化对随后心血管事件的影响。

Sodium reduction and weight loss lead to decreased blood pressure (BP). Among hypertensives, BP lowering leads to decreased risk of MI, stroke, and cardiovascular death. Nonetheless, concerns have been raised about increased numbers of cardiovascular events among individuals with low sodium intake or large weight changes. The proposed prospective observational follow-up of the Trials of Hypertension Prevention (TOHP) will include cardiovascular events among the 4, 507 surviving participants from the ten clinical centers involved in Phases I and II of TOHP. Phase I was a randomized trial of the effects of seen non- pharmacologic interventions, including sodium reduction and weight loss, on BP over 18 months of follow-up with 2,182 participants. Phase II examined the effects of sodium reduction and weight loss on BP over a longer 36-month period in a randomized 2X2 factorial design with 2,382 participants. During follow-up in Phases I and II of TOHP, several measures of both weight and sodium excretion were carefully obtained on all participants. The proposed prospective observational follow-up will specifically examine whether these values, with an emphasis on average level of sodium excretion and weight changes are predictive of later cardiovascular disease. The follow-up will be conducted centrally by mail from the Division of Preventive Medicine, which served as the Coordinating Center for Phases I and II, and which has been very successful in conducting such large-scale studies by mail. Information on cardiovascular events subsequent to the trial periods will be collected through June, 2003, representing an average follow-up of approximately fourteen years from the end of Phase I and eight years from the end of Phase II. This cohort provides a unique resource to address the impact in a normotensive population of salt restriction and weight change on subsequent cardiovascular events.