DIETARY PATTERNS AND BLOOD PRESSURE

这项研究的目的是确定一种饮食模式，将降低血液 压力 过去的研究已经检查了 膳食脂肪和蛋白质数量和类型已经证明， 令人信服的效果。 一直以来， 与低血压有关的是素食主义。 我们认为 素食中的微量营养素组合最有可能 它的扩张效应的中介。 虽然素食模式也是 极端推荐给我们的一般人群，同样的微量营养素 摄入量可以通过沿着足够的肉、鱼和奶制品来实现 产品，使整体模式可口。 因此，我们建议 一项多中心试验将测试两种饮食对高血压的影响。 微量营养素（钾、钙和镁）与“典型” 480名受试者（男：女50：50， 黑人：高加索人），基线舒张压80-99 mmHg。 的 治疗饮食将在常量营养素不同：一个与“不利” 对照饮食的常量营养素和另一种动物脂肪较低 多不饱和脂肪与饱和脂肪的比例更好。 我们假设 两种治疗饮食都能降低血压（证明 消化效果与微量营养素含量有关，而不是与大量营养素含量有关， 只有低动物脂肪的饮食也会降低胆固醇水平。 因此，在本发明中， 高微量营养素、低脂肪饮食对总体心脏健康是最佳的。 减少风险。 毫无疑问，一些受试者将大大降低血压， 这种饮食和一些不会。 为了帮助确定这些决定因素， “反应者”，我们建议在试验的出发点描述受试者的特征 根据人口统计学，通常的饮食摄入量，和几个“高血压” 范例（肾素状态，盐敏感性，胰岛素抵抗， 调制剂/非调制剂）。 考虑到将在本研究中研究的大量受试者， 多中心试验，种族和性别分布均匀， 这项试验应该明确确定饮食的重要性， 微量营养素含量高的模式作为降低血压的手段。 通过对受试者进行适当的试验前分类，它还将 明确证明在哪些受试者组中，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.