OBSERVATIONAL COHORT STUDY OF SODIUM, WEIGHT AND CVD

钠减少和体重减轻导致血压降低（BP）。在高血压患者中，血压降低导致MI、中风和心血管死亡的风险降低。尽管如此，人们还是对钠摄入量低或体重变化大的个体心血管事件数量增加表示担忧。高血压预防试验（TOHP）的前瞻性观察性随访将包括TOHP I期和II期10个临床中心的4507名存活受试者的心血管事件。I期是一项随机试验，观察了非药物干预（包括减钠和减肥）对血压的影响，随访时间超过18个月，共有2，182名参与者。第二阶段研究了在36个月的时间内减少钠和体重减轻对血压的影响，采用随机2X2析因设计，共有2,382名参与者。在TOHP I期和II期的随访期间，对所有参与者仔细获得了体重和钠排泄的几项指标。拟议的前瞻性观察性随访将专门检查这些值，重点是钠排泄的平均水平和体重变化是否可预测后期心血管疾病。后续行动将由预防医学司通过邮件集中进行，该司是第一和第二阶段的协调中心，在通过邮件进行此类大规模研究方面非常成功。将收集至2003年6月的试验期后的心血管事件信息，代表自I期结束后平均随访约14年，自II期结束后平均随访约8年。该队列研究提供了一个独特的资源，以解决血压正常人群中盐限制和体重变化对随后心血管事件的影响。

Sodium reduction and weight loss lead to decreased blood pressure (BP). Among hypertensives, BP lowering leads to decreased risk of MI, stroke, and cardiovascular death. Nonetheless, concerns have been raised about increased numbers of cardiovascular events among individuals with low sodium intake or large weight changes. The proposed prospective observational follow-up of the Trials of Hypertension Prevention (TOHP) will include cardiovascular events among the 4, 507 surviving participants from the ten clinical centers involved in Phases I and II of TOHP. Phase I was a randomized trial of the effects of seen non- pharmacologic interventions, including sodium reduction and weight loss, on BP over 18 months of follow-up with 2,182 participants. Phase II examined the effects of sodium reduction and weight loss on BP over a longer 36-month period in a randomized 2X2 factorial design with 2,382 participants. During follow-up in Phases I and II of TOHP, several measures of both weight and sodium excretion were carefully obtained on all participants. The proposed prospective observational follow-up will specifically examine whether these values, with an emphasis on average level of sodium excretion and weight changes are predictive of later cardiovascular disease. The follow-up will be conducted centrally by mail from the Division of Preventive Medicine, which served as the Coordinating Center for Phases I and II, and which has been very successful in conducting such large-scale studies by mail. Information on cardiovascular events subsequent to the trial periods will be collected through June, 2003, representing an average follow-up of approximately fourteen years from the end of Phase I and eight years from the end of Phase II. This cohort provides a unique resource to address the impact in a normotensive population of salt restriction and weight change on subsequent cardiovascular events.