DIETARY PATTERNS AND BLOOD PRESSURE

这项研究的目的是找出一种可以降低血液的饮食模式 压力。过去的研究已经检查了阿司匹林的血压效应 饮食中脂肪和蛋白质的数量和类型没有显示出 令人信服的效果。一直以来最稳定的饮食模式 与较低血压相关的是素食主义。我们相信 素食中的微量营养素组合是最有可能的 其降压作用的中介物。尽管素食模式太过 向我们的普通民众推荐极端的，相同的微量营养素 在摄取足够的肉类、鱼和乳制品的同时，也可以达到摄入量。 产品要使整体图案美观大方。因此，我们建议 多中心试验将测试两种高饮食对血压的影响 微量营养素(钾、钙和镁)与“典型” 美国480名受试者的饮食控制(男女各占50：50 黑人：高加索人)，基础舒张压80-99毫米汞柱。这个 治疗饮食将在常量营养素方面有所不同：一种是“不良”的 对照日粮和动物脂肪含量较低组的常量营养素 和一个更好的多不饱和：饱和脂肪比例。我们假设 这两种治疗饮食都会降低血压(表明 降压作用与微观--而不是宏观--营养素含量有关)，但 只有低动物脂肪饮食才能降低胆固醇水平。因此， 高微量营养素、低脂肪饮食对整体心脏是最理想的。 降低风险。 毫无疑问，一些受试者可以通过 这种节食和一些节食不会。以帮助确定这些因素的决定因素 “应答者”，我们建议在试验现场描述受试者的特征 根据人口学资料，平时的饮食摄入量，还有几个“高血压” 范例(肾素状态、盐敏感性、胰岛素抵抗和 调制器/非调制器)。 考虑到将在本课程中研究的课题数量可观 多中心试验，种族和性别分布均匀， 这项试验应该明确地确定饮食的重要性 作为一种降低血压的方法，微量营养素含量较高。 有了适当的审前科目分类，它还将 明确地证明在哪些受试者中这些饮食可能 是最有益的。

The aim of this study is to identify a diet pattern that will lower blood pressure. Past studies which have examined the blood pressure effect of the amount and type of dietary fat and protein have demonstrated no convincing effect. The diet pattern which has been most consistently associated with lower blood pressure is vegetarianism. We believe that the micronutrient combination of the vegetarian diet is the most likely mediator of its hypotensive effect. Although a vegetarian pattern is too extreme to recommend to our general population, the same micronutrient intake can be achieved along with sufficient meat, fish, and dairy products to make the overall pattern palatable. Therefore, our proposed multi-center trial would test the blood pressure effect of two diets high in micronutrients (potassium, calcium, and magnesium) vs a "typical" American control diet in 480 subjects (50:50 male:female and black:caucasian) with baseline diastolic blood pressure 80-99 mmHg. The treatment diets will differ in macronutrients: one with the "adverse" macronutrients of the control diet and the other with lower animal fat and a better polyunsaturated:saturated fat ratio. We hypothesize that both treatment diets will lower blood pressure (demonstrating that the hypotensive effect is related to micro- not macro-nutrient content), but only the low animal fat diet will also lower cholesterol levels. Thus, the high micronutrient, low fat diet would be optimal for overall cardiac risk reduction. Undoubtedly, some subjects will lower blood pressure substantially with this diet and some will not. To help identify the determinants of these "responders", we propose to characterize subjects at the trial's out set according to demographics, usual diet intake, and several "hypertensive" paradigms (renin status, salt-sensitivity, insulin resistance, and modulator/nonmodulators). Considering the sizable number of subjects which will be studied in this multi-center trial, and the even distribution of ethnicity and gender, this trial should definitively establish the importance of dietary pattern high in micronutrients as a means of lowering blood pressure. With appropriate pre-trial classification of subjects, it will also definitively demonstrate in which groups of subjects these diets might be most beneficial.