Effect of Dietary Approaches to Stop Hypertension (DASH) Diet on Heart Failure Status in Older Adults

降血压饮食方法 (DASH) 饮食对老年人心力衰竭状况的影响

• 批准号: 10666118
• 负责人: Elisabeth Lilian Pia Sattler
• 金额: $ 23.69万
• 依托单位: UNIVERSITY OF GEORGIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666118
• 关键词: Acute; Address; Aging; Biological Markers; Blood Pressure; Cardiac; Cardiology; Clinical; Clinical Nutrition; Clinical Research; Clinical Sciences; Clinical Trials; Congestive Heart Failure; Consumption; Cross-Over Studies; DASH diet; Data; Development; Devices; Diagnosis; Diastolic blood pressure; Diet; Dietary Intervention; Diuretics; EFRAC; Early Intervention; Edema; Elderly; Electrolytes; Energy Intake; Environment; Functional disorder; Gastrointestinal tract structure; Health Care Costs; Health Promotion; Healthcare; Heart Rate; Heart failure; Home; Hospitalization; Human; Implant; Infrastructure; Intake; Intervention; Intervention Studies; Knowledge; Laboratories; Length; Malnutrition; Modality; Monitor; Natriuretic Peptides; Nutritional; Nutritional Support; Operative Surgical Procedures; Outcome; Oxidative Stress; Parents; Participant; Patient Care; Patients; Pharmaceutical Preparations; Pharmacotherapy; Phase; Physiological; Pilot Projects; Prevention; Prognosis; Prognostic Marker; Public Health; Quality of life; Randomized; Recommendation; Research; Research Design; Research Project Grants; Safety; Shortness of Breath; Sodium; Symptoms; Target Populations; Therapeutic; Translational Research; Ventricular Function; Visit; Weight Gain; Woman; aged; arterial stiffness; cardiac cachexia; care burden; cost; design; dietary restriction; economic cost; experience; feeding; health related quality of life; hemodynamics; hospital readmission; implantable device; improved; micronutrient deficiency; monitoring device; mortality; novel; nutrition; older patient; patient oriented research; preservation; pro-brain natriuretic peptide (1-76); programs; prospective test; pulmonary arterial pressure; research clinical testing; response; telemonitoring; treatment as usual; trend

PROJECT SUMMARY/ABSTRACT This application is in response to PA-20-194 Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required). While adequate nutrition is known to promote health-related quality of life by addressing malnutrition and promoting optimal functioning among older adults, little is known about the impact of clinical nutrition intervention as a therapeutic modality on heart failure (HF) outcomes. New patient-oriented research on the effects of nutritional therapy on HF status and progression would greatly benefit older HF patients who commonly experience malnutrition. Given the high human and economic costs associated with HF complications among older adults, the development and clinical testing of nutritional standards represents a much needed, low-cost, and prudent strategy likely to improve HF outcomes. This pilot study is designed to prospectively test the effect of a prescribed, laboratory-prepared, home-delivered Dietary Approaches to Stop Hypertension (DASH) diet intervention on clinically important markers of HF status. We will generate important data of the effect of the dietary intervention on pulmonary artery pressures (PAPs) in patients with implanted CardioMEMS™ hemodynamic monitoring device, a novel and groundbreaking approach to the early prediction of acute decompensated HF and effective strategy to reduce rates of HF hospitalizations and mortality. Our target population are older adults aged 65+ years with a diagnosis of HF who are stable on pharmacotherapy. The central hypothesis is that short-term consumption of a DASH diet significantly improves HF status among older patients. We will conduct a randomized crossover clinical study design (n=38, 50% women). Outcomes after 4 weeks on the DASH diet will be compared to a 4-week “own diet” phase during which patients will consume their self-selected, self-prepared diet based on usual care recommendations. Our specific aims are: 1) to determine the effect of consuming a DASH diet for 4 weeks on levels of the natriuretic peptide (NP) biomarkers BNP and NT-ProBNP which are strong prognostic markers in patients with chronic HF; and 2) to examine the effect of consuming a DASH diet for 4 weeks on PAPs in HF patients with implanted CardioMEMS™ device. We anticipate that HF status and PAPs will respond positively and timely to the consumption of a 4-week 2,300 mg sodium-restricted DASH diet intervention. The study is supported by preliminary data demonstrating safety, feasibility, and acceptability of the proposed intervention within the Georgia Clinical and Translational Science Alliance (GA CTSA) infrastructure. In addition, the study team has long-standing experience and expertise in cardiology, pathophysiology, nutrition, public health, and aging related research within the GA CTSA environment and is well suited to carry out the proposed research.

项目总结/摘要 本申请是对PA-20-194探索/发展研究资助计划（父R21）的回应 需要临床试验）。虽然人们知道充足的营养可以通过以下方式提高与健康有关的生活质量： 解决营养不良和促进老年人的最佳功能， 临床营养干预作为心力衰竭（HF）结局的治疗方式。新患者导向 研究营养治疗对HF状态和进展的影响将大大有益于老年HF患者 经常出现营养不良的患者。鉴于与之相关的高昂的人力和经济成本， 老年人中的HF并发症，营养标准的开发和临床测试代表了一种 急需的、低成本的、谨慎的策略可能改善HF结局。这项试点研究旨在 前瞻性地测试处方的，实验室准备的，家庭提供的饮食方法的效果， 高血压（DASH）饮食干预对HF状态的临床重要标志物的影响。我们将产生重要的 饮食干预对植入性肺动脉高压患者肺动脉压（PAP）影响的数据 MEMS ™血流动力学监测设备，一种新颖的突破性早期预测方法 急性失代偿性心力衰竭和有效的策略，以减少心力衰竭住院率和死亡率。我们 目标人群为65岁以上诊断为HF且经药物治疗后病情稳定老年人。 中心假设是短期食用DASH饮食显著改善HF状态 老年患者中。我们将进行随机交叉临床研究设计（n=38，50%女性）。 DASH饮食4周后的结果将与为期4周的“自己饮食”阶段进行比较，在此期间， 患者将根据通常的护理建议食用他们自己选择、自己准备的饮食。我们 具体目标是：1）确定食用DASH饮食4周对利钠尿肽水平的影响， 肽（NP）生物标志物BNP和NT-ProBNP是慢性胰腺炎患者的强预后标志物， HF;和2）检查DASH饮食4周对植入了DASH的HF患者PAP的影响。 MEMS ™器件。我们预计HF状态和PAP将积极及时地响应 消耗4周的2，300 mg钠限制的DASH饮食干预。这项研究得到了 初步数据表明， 格鲁吉亚临床和转化科学联盟（GA CTSA）基础设施。此外，研究小组还 在心脏病学、病理生理学、营养学、公共卫生和老龄化方面的长期经验和专业知识 在GA CTSA环境中进行相关研究，非常适合进行拟议的研究。