A CLINICAL-TRIAL OF THE EFFECTS OF DIETARY PATTERNS ON BLOOD-PRESSURE

Citation
Lj. Appel et al., A CLINICAL-TRIAL OF THE EFFECTS OF DIETARY PATTERNS ON BLOOD-PRESSURE, The New England journal of medicine, 336(16), 1997, pp. 1117-1124
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, General & Internal
ISSN journal
0028-4793
Volume
336
Issue
16
Year of publication
1997
Pages
1117 - 1124
Database
ISI
SICI code
0028-4793(1997)336:16<1117:ACOTEO>2.0.ZU;2-1
Abstract
Background It is known that obesity, sodium intake, and alcohol consum ption influence blood pressure. In this clinical trial, Dietary Approa ches to Stop Hypertension, we assessed the effects of dietary patterns on blood pressure. Methods We enrolled 459 adults with systolic blood pressures of less than 160 mm Hg and diastolic blood pressures of 80 to 95 mm Hg. For three weeks, the subjects were fed a control diet tha t was low in fruits, vegetables, and dairy products, with a fat conten t typical of the average diet in the United States. They were then ran domly assigned to receive for eight weeks the control diet, a diet ric h in fruits and vegetables, or a ''combination'' diet rich in fruits, vegetables, and low-fat dairy products and with reduced saturated and total fat. Sodium intake and body weight were maintained at constant l evels. Results At base line, the mean (+/-SD) systolic and diastolic b lood pressures were 131.3+/-10.8 mm Hg and 84.+/-4.7 mm Hg, respective ly. The combination diet reduced systolic and diastolic blood pressure by 5.5 and 3.0 mm Hg more, respectively, than the control diet (P<0.0 01 for each); the fruits-and-vegetables diet reduced systolic blood pr essure by 2.8 mm Hg more (P<0.001) and diastolic blood pressure by 1.1 mm Hg more (P=0.07) than the control diet. Among the 133 subjects wit h hypertension (systolic pressure, greater than or equal to 140 mm Hg; diastolic pressure, greater than or equal to 90 mm Hg; or both), the combination diet reduced systolic and diastolic blood pressure by 11.4 and 5.5 mm Hg more, respectively, than the control diet (P<0.001 for each); among the 326 subjects without hypertension, the corresponding reductions were 3.5 mm Hg (P<0.001) and 2.1 mm Hg (P=0.003). Conclusio ns A diet rich in fruits, vegetables, and low-fat dairy foods and with reduced saturated and total fat can substantially lower blood pressur e. This diet offers an additional nutritional approach to preventing a nd treating hypertension. (C) 1997, Massachusetts Medical Society.