Int'l Population on Macronutrients and BP - INTERMAP

描述（由申请人提供）：本申请要求支持国际合作INTERMAP研究中的进一步数据分析和报告工作-包括完成原始和扩展目标（假设检验和探索性分析）的工作。INTERMAP是一项基础流行病学调查，研究饮食因素（大分子和微量营养素）及其尿液代谢产物在大多数中老年人群血压水平不良病因学中的作用。在这一总体目标的背景下，一个特别的重点是帮助阐明这些饮食因素在解释受教育程度较低的人口阶层的更不利的BP模式中的作用，例如，在美国，受教育程度较低的非裔美国人，西班牙裔，白人。INTERMAP的目标是在这些重要问题上取得重大进展，基于其设计：大样本量的4，680名年龄在40-59岁之间的男性和女性，来自4个国家（中国，日本，英国，美国）。通过伦敦中心的成本分摊以及在此纳入5个正在进行的NHLBI支持项目的数据分析/报告目标，确保了成本效益。具体目标涉及阐明蛋白质、脂质、碳水化合物以及单个氨基酸、脂肪酸、糖、维生素、Ca、Mg、Fe、P、Cu、Se、纤维、咖啡因的量和类型对BP的影响。在控制BMI、酒精摄入量、Na、K、年龄、性别和其他混杂因素的情况下，正在检验的主要假设是：膳食蛋白质与BP呈负相关;教育与BP之间的负相关关系由多种膳食因素中的教育相关差异显著解释;膳食SFA、胆固醇、Keys评分、淀粉与BP呈直接相关; PFAs和P/S呈负相关。随机选择的参与者提供了2次定时的24小时尿液采集，用于评估Na、K、肌酐、尿素、Ca、Mg、大量和微量白蛋白尿、氨基酸、代谢物（NMR、HPLC、MS分析）和4次24小时饮食回忆。血压测量8次（4次访视）。这项研究由两个协调中心协调-芝加哥的西北大学和伦敦的帝国理工学院。在鲁汶和伦敦的中心实验室进行了尿液测定。24小时膳食回顾已转换为营养素（目前为75项，到2004年年中为83项），使用了4个国家特有的最新、广泛、高质量、标准化的国家数据库。多种饮食因素与血压关系的研究结果被用来估计人群营养的多种改善对血压的有利影响。反过来，这应该有助于加强对高血压一级预防的饮食建议，并使血压分布向下移动，以避免与目前不利水平相关的过度风险。

DESCRIPTION (provided by applicant): This application requests support for further data analysis and reporting work - - including for completion of work on original and expanded aims (hypothesis testing and exploratory analyses) - - in the international cooperative INTERMAP Study. INTERMAP is a basic epidemiologic investigation on the role of dietary factors (macroland micronutrients) and their urinary metabolites in the etiology of unfavorable blood pressure (BP) levels prevailing for a majority of middle-aged and older individuals. 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 strata, e.g., in the U.S. less educated African-Americans, Hispanics, Whites. INTERMAP aims to achieve a major advance on these important issues, based on its design: large sample size of 4,680 men and women ages 40-59 from 17 diverse population samples of varied ethnicity, SES, and dietary habits in 4 countries (China, Japan, U.K., U.S.). Cost effectiveness is assured by cost sharing by London centers and inclusion here of data analysis/reporting aims from 5 on-going NHLBI supported projects. Specific aims involve elucidating influences on BP of amount and type of protein, lipids, carbohydrates, also individual amino acids, fatty acids, sugars, vitamins, Ca, Mg, Fe, P, Cu, Se, fiber, caffeine. Primary hypotheses being 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-related differences in multiple dietary factors; there is a direct relation to BP of dietary SFA, cholesterol, Keys score, starch; there is an inverse relation of PFAs and of P/S. Participants, randomly selected, provided 2 timed 24-hr urine collections for assessment of Na, K, creatinine, urea, Ca, Mg, macro- and microalbuminuria, amino acids, metabolites (NMR, HPLC, MS analyses), and four 24-hr dietary recalls. BP was measured 8 times (4 visits). The study is coordinated by two Coordinating Centers - - Northwestern University, Chicago and Imperial College, London. Urinary determinations have proceeded at Central Laboratories in Leuven and London. 24-hr dietary recalls have been converted into nutrients (75 currently, 83 by mid-2004) with use of 4 country-specific up-to-date, extensive, high-quality, standardized national data bases. Findings on relations of multiple dietary factors to BP are being used to estimate favorable impact on BP of multiple improvements in nutrition by populations. This, in turn, should aid in enhancing dietary recommendations for primary prevention o1 hypertension, and for shifting BP distributions downward to avoid excess risk associated with present unfavorable levels.