OBSERVATIONAL COHORT STUDY OF SODIUM, WEIGHT AND CVD

钠的减少和体重的减轻导致血压(BP)下降。在高血压患者中，血压降低会降低心肌梗死、中风和心血管死亡的风险。尽管如此，对于低钠摄入量或体重变化较大的个体心血管事件数量增加的担忧已经提出。拟议的高血压预防试验(TOHP)的前瞻性观察后续研究将包括TOHP第一阶段和第二阶段涉及的10个临床中心的4507名幸存参与者的心血管事件。第一阶段是一项随机试验，对包括减钠和减肥在内的非药物干预措施对血压的影响进行了18个月的随访，共有2,182名参与者。第二阶段采用2,382名参与者的随机2×2析因设计，在较长的36个月时间内研究了钠减少和体重减轻对血压的影响。在TOHP第一阶段和第二阶段的随访中，仔细测量了所有参与者的体重和钠排泄量。拟议的前瞻性观察随访将专门检查这些值是否预示着以后的心血管疾病，重点是钠排泄的平均水平和体重变化。跟进工作将由预防医学部通过邮寄集中进行，预防医学部是第一阶段和第二阶段的协调中心，在进行如此大规模的邮寄研究方面非常成功。试验结束后心血管事件的信息将收集到2003年6月，从第一阶段结束到第二阶段结束，平均随访时间约为14年，这一队列提供了一个独特的资源，以解决在血压正常的人群中限制盐分和体重变化对后续心血管事件的影响。

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.