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Cardiovascular and renal hemodynamics and the DASH diet

心血管和肾脏血流动力学以及 DASH 饮食

基本信息

批准号：
7405373
负责人：
PAUL R CONLIN
金额：
$ 34.76万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-06-01 至 2012-03-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): This application proposes to expand upon the findings of the DASH study, which showed that a dietary pattern emphasizing fruits, vegetables and low fat dairy products and is overall reduced in total and saturated fat significantly lowers blood pressure (BP). The DASH diet is particularly effective in African Americans and in individuals with systolic hypertension. However, we do not know if the DASH diet affects the pathophysiology of the hypertensive process. Our preliminary data support the possibility that the DASH diet interrupts the renin-angiotensin system. This raises the intriguing possibility that the DASH diet will favorably impact on cardiovascular and renal hemodynamics in patients with isolated systolic hypertension. Therefore, the central hypothesis of this application is that the DASH diet affects central aortic stiffness, diastolic relaxation and renal and vascular reactivity to angiotensin II (Ang II) by lowering tissue renin-angiotensin system activity. We will test this hypothesis in patients with isolated systolic hypertension, by determining if the DASH diet (1) reduces central aortic stiffness, as measured by characteristic impedance (Zc) and carotid-femoral pulse wave velocity (CF-PWV), (2) improves diastolic relaxation, as measured by early diastolic myocardial velocities (Ea), (3) vasodilates renal blood flow and enhances the renal and vascular response to Ang II, and (4) affects these hemodynamic parameters in a manner that is similar to ACE inhibition. We will study 55 participants with isolated systolic hypertension in a randomized, cross-over feeding study of the DASH diet and a control diet. Participants will enter a 2- week run-in period on the control diet followed by two 6-week feeding periods eating the control diet or the DASH diet in random order. After each feeding period, conduit vessel hemodynamic measurements, diastolic relaxation and renal and vascular responses to Ang II will be measured before and after captopril administration. Findings from these studies will determine if the DASH diet favorably affects mechanisms that are altered by the hypertensive process, including renal and cardiac performance, in a group of individuals at higher cardiovascular risk.

描述(由申请人提供)：本申请建议扩展DASH研究的结果，该研究表明，强调水果、蔬菜和低脂乳制品的饮食模式，总体上减少总脂肪和饱和脂肪，可显著降低血压(BP)。DASH饮食对非裔美国人和患有收缩期高血压的人特别有效。然而，我们不知道DASH饮食是否会影响高血压过程的病理生理学。我们的初步数据支持DASH饮食中断肾素-血管紧张素系统的可能性。这提出了一种耐人寻味的可能性，即DASH饮食将对单纯收缩期高血压患者的心血管和肾脏血流动力学产生有利影响。因此，这一应用的中心假设是，DASH饮食通过降低组织肾素-血管紧张素系统活性而影响中央主动脉僵硬、舒张期松弛以及肾脏和血管对血管紧张素II(Ang II)的反应性。我们将在单纯性收缩期高血压患者中验证这一假设，方法是确定DASH饮食(1)是否降低了特征阻抗(Zc)和颈动脉-股动脉脉搏波速度(Cf-PWV)测量的中央主动脉僵硬度，(2)改善了舒张期早期心肌速度(EA)测量的舒张期松弛，(3)血管扩张肾血流，并增强了肾脏和血管对血管紧张素转换酶II的反应，以及(4)以类似于ACE抑制的方式影响这些血流动力学参数。我们将对55名患有单纯收缩期高血压的参与者进行随机交叉喂养研究，研究对象为DASH饮食和对照饮食。参与者将进入为期2周的对照组饮食磨合期，随后两个为期6周的喂食期按随机顺序食用对照组饮食或DASH饮食。在每个喂养期后，将在服用卡托普利前后测量管道血管血流动力学、舒张期松弛以及肾脏和血管对血管紧张素转换酶II的反应。这些研究的结果将确定DASH饮食是否有利于影响心血管风险较高的一组个人的高血压过程改变的机制，包括肾脏和心脏功能。