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Соль и артериальная гипертония. Возможности немедикаментозной профилактики артериальной гипертонии коррекцией питания в организованной популяции у мужчин и женщин от 25 до 49 лет в течение 3-летнего периода
Соль и артериальная гипертония. Возможности немедикаментозной профилактики артериальной гипертонии коррекцией питания в организованной популяции у мужчин и женщин от 25 до 49 лет в течение 3-летнего периода
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Аннотация
Существует много доказательств взаимосвязи между потреблением соли и уровнем артериального давления (АД). Ограничение потребления натрия значительно снижает АД. Целью настоящего исследования было изучение эффективности снижения АД при ограничении потребления соли у мужчин и женщин с высоким нормальным АД. После 3-летнего диетического вмешательства выявлено достоверное снижение систолического (САД) и диастолического АД (ДАД) у мужчин и женщин в группе вмешательства (р<0,05) по сравнению с контрольной группой, в которой отмечена естественная динамика АД, наблюдалось достоверное увеличение АД в течение 3-летнего периода (р<0,05). Кроме того, отмечено достоверное снижение массы тела в группе вмешательства по сравнению с группой контроля. Снижение потребления соли достоверно снижает САД и ДАД у мужчин и женщин с высоким нормальным АД в течение длительного периода наблюдения по сравнению с контрольной группой.
Ключевые слова: артериальная гипертония, профилактика, соль, проспективное популяционное исследование.
Key words: hypertension, prevention, sodium, prospective population study.
Ключевые слова: артериальная гипертония, профилактика, соль, проспективное популяционное исследование.
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Key words: hypertension, prevention, sodium, prospective population study.
Полный текст
Список литературы
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17. Dustan HP, Tarazi RC, Bravo EL. Diuretic and diet treatment of hypertension. Arch Intern Med 1974; 133: 1007–11.
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2. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J 2012; 33: 1635–701.
3. 2007 Guidelines for the management of arterial hypertension. Eur Heart J 2007; 28: 1462–536.
4. Chobanian AV, Bakris GL, Black HR et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–52.
5. Kempner W. Treatment of hypertensive vascular disease with rice diet. Am J Med 1948; 4: 545–77.
6. Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Heath and Nutrition Examination Survey (NHANES I). Lancet 1998; 351: 781–5.
7. He J, Klag MJ, Whelton PK et al. Migration,blood pressure pattern, and hypertension: the Yi Migrant Study. Am J Epidemiol 1991; 134: 1085–101.
8. Forte JG, Miguel JM, Miguel MJ et al. Salt and blood pressure: a community trial. J Hum Hypertens 1989; 3: 179–84.
9. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ 1988; 297: 319–28.
10. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38: 791–813.
11. Graudal NA, Hubeck-Graudal T, Jürgens G. Effects of low-sodium diet vs. highsodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review). Am J Hypertens 2012; 25: 1–15.
12. Vasan RS, Larson MG, Leip EP et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001; 358: 1682–6.
13. Vasan RS, Larson MG, Leip EP et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 45: 1291–7.
14. Appel LJ, Moore TJ, Obarzanek E et al. A clinical trial of the effects ofdietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–24.
15. Elliott P, Stamler J, Nichols R et al. Intersalt revisited: further analyses of 24h sodium excretion and blood pressurewithin and across populations. Intersalt Cooperative Research Group. BMJ 1996; 312: 1249–53.
16. Fitzsimons JT. Angiotensin, thirst, and sodium appetite. Physiol Rev 1998; 78: 583–686.
17. Dustan HP, Tarazi RC, Bravo EL. Diuretic and diet treatment of hypertension. Arch Intern Med 1974; 133: 1007–11.
18. Culter JA, Follmann D, Elliott P and Suhl I. An overview ofrandomized trials of sodium reduction and blood pressure.Hypertension 1991; 17 Suppl. I, (1): 27–33.
19. Gonzalez MC, Cohen HW, Sealey JE et al. Enduring direct association of baseline plasma renin activity with all-cause and cardiovascular mortality in hypertensive patients. Am J Hypertens 2011; 24: 1181–6.
20. Furberg CD. Public Health Policies: No Place for Surrogates. Am J Hypertens 2012; 25: 21.
21. Sacks FM, Svetkey LP, Vollmer WM et al. Effects on blood pressure of reduced dietary sodium and the dietaryapproaches to stop hypertension (DASH) diet. N Engl J Med 2001; 344: 3–10.
22. Cook NR, Cutler JA, Obarzanek E et al for the Trials of Hypertension Prevention Collaborative Research Group. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP) BMJ 2007; 334: 885.
23. Blackburn H. Primary Prevention of High Blood Pressure. A Population Approach. Ann Clin Res 1983; 16 (Suppl. 43): 11–7.
24. National Institute for Health and Clinical Excellence (NICE). Guidance on the prevention of cardiovascular disease at the population level; http://guidance.nice.org.uk/PH25 (Access verified 14 July 2010).
2. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J 2012; 33: 1635–701.
3. 2007 Guidelines for the management of arterial hypertension. Eur Heart J 2007; 28: 1462–536.
4. Chobanian AV, Bakris GL, Black HR et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–52.
5. Kempner W. Treatment of hypertensive vascular disease with rice diet. Am J Med 1948; 4: 545–77.
6. Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Heath and Nutrition Examination Survey (NHANES I). Lancet 1998; 351: 781–5.
7. He J, Klag MJ, Whelton PK et al. Migration,blood pressure pattern, and hypertension: the Yi Migrant Study. Am J Epidemiol 1991; 134: 1085–101.
8. Forte JG, Miguel JM, Miguel MJ et al. Salt and blood pressure: a community trial. J Hum Hypertens 1989; 3: 179–84.
9. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ 1988; 297: 319–28.
10. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38: 791–813.
11. Graudal NA, Hubeck-Graudal T, Jürgens G. Effects of low-sodium diet vs. highsodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review). Am J Hypertens 2012; 25: 1–15.
12. Vasan RS, Larson MG, Leip EP et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001; 358: 1682–6.
13. Vasan RS, Larson MG, Leip EP et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 45: 1291–7.
14. Appel LJ, Moore TJ, Obarzanek E et al. A clinical trial of the effects ofdietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–24.
15. Elliott P, Stamler J, Nichols R et al. Intersalt revisited: further analyses of 24h sodium excretion and blood pressurewithin and across populations. Intersalt Cooperative Research Group. BMJ 1996; 312: 1249–53.
16. Fitzsimons JT. Angiotensin, thirst, and sodium appetite. Physiol Rev 1998; 78: 583–686.
17. Dustan HP, Tarazi RC, Bravo EL. Diuretic and diet treatment of hypertension. Arch Intern Med 1974; 133: 1007–11.
18. Culter JA, Follmann D, Elliott P and Suhl I. An overview ofrandomized trials of sodium reduction and blood pressure.Hypertension 1991; 17 Suppl. I, (1): 27–33.
19. Gonzalez MC, Cohen HW, Sealey JE et al. Enduring direct association of baseline plasma renin activity with all-cause and cardiovascular mortality in hypertensive patients. Am J Hypertens 2011; 24: 1181–6.
20. Furberg CD. Public Health Policies: No Place for Surrogates. Am J Hypertens 2012; 25: 21.
21. Sacks FM, Svetkey LP, Vollmer WM et al. Effects on blood pressure of reduced dietary sodium and the dietaryapproaches to stop hypertension (DASH) diet. N Engl J Med 2001; 344: 3–10.
22. Cook NR, Cutler JA, Obarzanek E et al for the Trials of Hypertension Prevention Collaborative Research Group. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP) BMJ 2007; 334: 885.
23. Blackburn H. Primary Prevention of High Blood Pressure. A Population Approach. Ann Clin Res 1983; 16 (Suppl. 43): 11–7.
24. National Institute for Health and Clinical Excellence (NICE). Guidance on the prevention of cardiovascular disease at the population level; http://guidance.nice.org.uk/PH25 (Access verified 14 July 2010).
________________________________________________
2. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J 2012; 33: 1635–701.
3. 2007 Guidelines for the management of arterial hypertension. Eur Heart J 2007; 28: 1462–536.
4. Chobanian AV, Bakris GL, Black HR et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–52.
5. Kempner W. Treatment of hypertensive vascular disease with rice diet. Am J Med 1948; 4: 545–77.
6. Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Heath and Nutrition Examination Survey (NHANES I). Lancet 1998; 351: 781–5.
7. He J, Klag MJ, Whelton PK et al. Migration,blood pressure pattern, and hypertension: the Yi Migrant Study. Am J Epidemiol 1991; 134: 1085–101.
8. Forte JG, Miguel JM, Miguel MJ et al. Salt and blood pressure: a community trial. J Hum Hypertens 1989; 3: 179–84.
9. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ 1988; 297: 319–28.
10. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38: 791–813.
11. Graudal NA, Hubeck-Graudal T, Jürgens G. Effects of low-sodium diet vs. highsodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review). Am J Hypertens 2012; 25: 1–15.
12. Vasan RS, Larson MG, Leip EP et al. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001; 358: 1682–6.
13. Vasan RS, Larson MG, Leip EP et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 45: 1291–7.
14. Appel LJ, Moore TJ, Obarzanek E et al. A clinical trial of the effects ofdietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–24.
15. Elliott P, Stamler J, Nichols R et al. Intersalt revisited: further analyses of 24h sodium excretion and blood pressurewithin and across populations. Intersalt Cooperative Research Group. BMJ 1996; 312: 1249–53.
16. Fitzsimons JT. Angiotensin, thirst, and sodium appetite. Physiol Rev 1998; 78: 583–686.
17. Dustan HP, Tarazi RC, Bravo EL. Diuretic and diet treatment of hypertension. Arch Intern Med 1974; 133: 1007–11.
18. Culter JA, Follmann D, Elliott P and Suhl I. An overview ofrandomized trials of sodium reduction and blood pressure.Hypertension 1991; 17 Suppl. I, (1): 27–33.
19. Gonzalez MC, Cohen HW, Sealey JE et al. Enduring direct association of baseline plasma renin activity with all-cause and cardiovascular mortality in hypertensive patients. Am J Hypertens 2011; 24: 1181–6.
20. Furberg CD. Public Health Policies: No Place for Surrogates. Am J Hypertens 2012; 25: 21.
21. Sacks FM, Svetkey LP, Vollmer WM et al. Effects on blood pressure of reduced dietary sodium and the dietaryapproaches to stop hypertension (DASH) diet. N Engl J Med 2001; 344: 3–10.
22. Cook NR, Cutler JA, Obarzanek E et al for the Trials of Hypertension Prevention Collaborative Research Group. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP) BMJ 2007; 334: 885.
23. Blackburn H. Primary Prevention of High Blood Pressure. A Population Approach. Ann Clin Res 1983; 16 (Suppl. 43): 11–7.
24. National Institute for Health and Clinical Excellence (NICE). Guidance on the prevention of cardiovascular disease at the population level; http://guidance.nice.org.uk/PH25 (Access verified 14 July 2010).
Авторы
О.В.Молчанова*, А.Н.Бритов, Г.Ф.Андреева
ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава РФ, Москва
*ovm-337@mail.ru
State Research Center for Preventive Medicine, Ministry of Health of the Russian Federation, Moscow
*ovm-337@mail.ru
ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава РФ, Москва
*ovm-337@mail.ru
________________________________________________
State Research Center for Preventive Medicine, Ministry of Health of the Russian Federation, Moscow
*ovm-337@mail.ru
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