A HEALTH PROMOTION PROGRAM INCORPORATING FISH FOR WITHDRAWAL OF ANTIHYPERTENSIVE DRUGS IN OVERWEIGHT, HYPERTENSIVES

肥胖是导致高血压和血脂水平异常的主要生活方式因素。减肥和鱼粉和鱼油中的omega-3脂肪酸已被单独证明可以降低高血压患者的血压和改善血脂。我们之前已经证明，在接受治疗的高血压患者中，作为减肥方案的一部分，每天吃鱼粉在4个月的时间里实现了显著的血压下降。我们现在的目标是评估正在服用高血压药物的超重男性和女性的健康促进计划的效果，该计划的重点是改善饮食教育，并包括从鱼类中增加饮食中的omega-3脂肪酸。该计划还将包括增加体力活动、戒烟和减少饮酒。其主要目的是降低血压，并使抗高血压治疗得以取消。据建议，该计划可以改善血脂、血糖和胰岛素，以及凝血系统的组成部分。鉴于高血压心血管疾病的高患病率，这一结果应该对公共卫生具有重要意义。将从普通社区招募190名年龄在40-70岁之间的接受高血压治疗的男性和女性。患者将被随机分配到：1)继续他们通常的饮食和日常护理，或2)开始一项健康促进计划，其中包括改善饮食习惯、增加体力活动、适度饮酒以及戒烟的信息。这些受试者将被给予一个单独的饮食计划，以减少卡路里的摄入量，他们还将被要求在一周至少四天的饮食中包括鱼餐。常规护理组(控制组)的受试者将获得国家心脏基金会提供的文献，并在研究结束时接受体重控制咨询。

Obesity is the major lifestyle factor predisposing to high blood pressure and abnormal blood fat levels. Weight reduction and omega-3 fatty acids from fish meals and fish oils have been shown independently to reduce blood pressure and improve blood fats in subjects with high blood pressure. We have previously shown that in treated hypertensive patients on a daily fish meal as part of a weight-reducing regimen, substantial blood pressure reduction was achieved over a 4 month period. We now aim to assess in overweight, men and women, who are taking medication for high blood pressure, the effects of a health promotion program which focuses on improved dietary education and includes increased dietary omega-3 fatty acids from fish. The program will also incorporate increased physical activity, quitting smoking and moderation of alcohol consumption. The primary aim is to reduce blood pressure and enable antihypertensive therapy to be withdrawn. It is proposed the program improve blood fats, blood glucose and insulin, and components of the clotting system. The results should have important implications for public health given the high prevalence of hypertensive cardiovascular disease. 190 men and women, 40-70 years, who are receiving treatment for high blood pressure, will be recruited from the general community. Patients will be randomly allocated to either: 1) continue their usual diet and usual care, or 2) commence a health promotion program which includes information on improved dietary habits, increased physical activity, moderation in alcohol consumption, as well as quitting smoking. These subjects will be given an individual dietary program to reduce caloric intake and they will also be asked to include fish meals as part of their diet on at least 4 days of the week. Subjects in the usual care group (control group) will be provided with literature from the National Heart Foundation and will be offered weight control counselling at the end of the study.