MACRONUTRIENTS AND BLOOD PRESSURE HAWAII INTERMAP CENTER

描述：(改编自调查人员摘要)INTERMAP是一个基本的 旨在帮助澄清悬而未决问题的流行病学调查 关于饮食因素，特别是大量营养素在饮食中的作用 普遍存在的不良血压水平的病因 美国大多数中老年人。一个 特别关注的是帮助阐明这些饮食因素的作用 在解释受教育程度较低的人更不利的BP模式时 人口阶层，例如在美国，受教育程度较低的黑人和 白色的。Intermap的设计仿照了经过测试的InterSalt模型： 大样本人数为5200人(男性2600人，女性2600人)，年龄在40-59岁之间 来自不同种族、社会经济地位和饮食习惯的20个人口样本 在4个国家(中国、日本、英国和美国；每人260人) 示例)。调查组将提供8人中的1人 多样化的美国Intermap样本。具体目标包括澄清 蛋白质、脂肪、碳水化合物的数量和种类对血压的影响， 还有氨基酸、钙、镁、抗氧化剂、纤维和咖啡因。 需要检验的主要假设，控制BMI，摄入量 酒精、年龄、性别和其他混杂因素如下：饮食蛋白质 与BP成反比；教育与BP成反比 与教育相关的差异在很大程度上解释了 膳食蛋白质摄入量与膳食SFA的血压有直接关系， 胆固醇、关键分数、淀粉；PFA和 P/S。随机选择的参与者将提供一次计时的24小时。 收集尿液以评估钠、钾、肌酸和尿素，他们 是要完成四个24小时。饮食召回。BP将被测量两次 在四次就诊中，每一次都是标准化和严格的质量 对所有程序进行控制。这项研究将由两个人协调进行 协调中心--西北大学、芝加哥和伦敦学校 卫生与热带医学系。要进行尿液测定 在比利时鲁汶的一个中心实验室。24小时饮食 召回将通过使用营养数据转换为营养素 明尼苏达大学营养协调中心的系统。 检验假设的数据分析将在伦敦进行 协调中心。总体研究结果被用来估计 营养的多重改善对BP的有利影响 人口。调查人员表示，这应该有助于 针对初级预防目标的其他饮食建议 高血压和向下移动血压分布以避免过量 与当前水平相关的风险一般高于最优水平。

DESCRIPTION: (Adapted from Investigator's Abstract) INTERMAP is a basic epidemiologic investigation designed to help clarify unanswered questions on the role of dietary factors, particularly macronutrients, in the etiology of unfavorable blood pressure (BP) levels prevailing for a majority of middle-aged and older individuals in the United States. A particular focus 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. in both less educated blacks and whites. INTERMAP's design is patterned after the tested INTERSALT model: large sample size of 5,200 persons (2,600 men and 2,600 women) ages 40-59 from 20 population samples of varied ethnicity, SES and dietary habits in 4 countries (China, Japan, U.K. and the U.S.; 260 persons per sample). The investigators' group is to provide one (1) of the 8 diverse U.S. INTERMAP samples. Specific aims involve elucidating influences on BP of amount and type of protein, lipids, carbohydrates, and also amino acids, Ca, Mg, antioxidants, fiber, and caffeine. Primary hypotheses to be tested, with control for BMI, intake of alcohol, age, sex, and other confounders are as follow: dietary protein is inversely related to BP; inverse relations between education and BP are significantly accounted for by education-related differences in dietary protein intake; there is a direct relation to BP of dietary SFA, cholesterol, Keys score, starch; there is an inverse relation of PFA and P/S. Participants, randomly selected, are to provide one timed 24-hr. urine collection for assessment of Na, K, creatine, and urea, and they are to complete four 24-hr. dietary recalls. BP is to be measured twice at each of four clinic visits, with standardization and strict quality control of all procedures. The study is to be coordinated by two Coordinating Centers--Northwestern University, Chicago and London School of Hygiene & Tropical Medicine. Urinary determinations are to be made at a Central Laboratory in Leuven, Belgium. Twenty-four hour dietary recalls are to be converted into nutrients with use of the Nutrition Data System of the University of Minnesota's Nutrition Coordinating Center. Data analyses to test hypotheses are to be done at the London Coordinating Center. Overall study findings are to be used to estimate favorable impact on BP of multiple improvements in nutrition by populations. The investigators state that this should aid in making additional dietary recommendations toward the goal of primary prevention of hypertension and shifting BP distributions downward to avoid excess risk associated with present levels generally above optimal.