Возможности коррекции артериального давления и метаболических нарушений при помощи диетических программ у пациентов с избыточной массой тела и ожирением
Возможности коррекции артериального давления и метаболических нарушений при помощи диетических программ у пациентов с избыточной массой тела и ожирением
Жернакова Ю.В, Железнова Е.А., Чазова И.Е. и др. Возможности коррекции артериального давления и метаболических нарушений при помощи диетических программ у пациентов с избыточной массой тела и ожирением. Системные гипертензии. 2019; 16 (2): 54–60. DOI: 10.26442/2075082X.2019.2.190354
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Zhernakova J.V., Zheleznova E.A., Chazova E.I et al. Possibilities of blood pressure and metabolic disorders correction by using diet programs in patients with overweight and obesity. Systemic Hypertension. 2019; 16 (2): 54–60. DOI: 10.26442/2075082X.2019.2.190354
Возможности коррекции артериального давления и метаболических нарушений при помощи диетических программ у пациентов с избыточной массой тела и ожирением
Жернакова Ю.В, Железнова Е.А., Чазова И.Е. и др. Возможности коррекции артериального давления и метаболических нарушений при помощи диетических программ у пациентов с избыточной массой тела и ожирением. Системные гипертензии. 2019; 16 (2): 54–60. DOI: 10.26442/2075082X.2019.2.190354
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Zhernakova J.V., Zheleznova E.A., Chazova E.I et al. Possibilities of blood pressure and metabolic disorders correction by using diet programs in patients with overweight and obesity. Systemic Hypertension. 2019; 16 (2): 54–60. DOI: 10.26442/2075082X.2019.2.190354
Артериальная гипертония (АГ) является одним из значимых факторов риска сердечно-сосудистых заболеваний. Большинство экспертов признают тесную взаимосвязь избыточной массы тела и ожирения с повышенным давлением. Неуклонный рост доли лиц с АГ, который последнее время прослеживается в эпидемиологических исследованиях, связывают с пандемией ожирения и сопутствующими ему состояниями – метаболическим синдромом и сахарным диабетом. В связи с этим становится явным, что коррекция массы тела играет ключевую роль среди модифицируемых факторов риска. Согласно последним рекомендациям Американской кардиологической ассоциации и Европейского общества кардиологов все пациенты с АГ должны следовать диетическим рекомендациям. Существует огромное количество рекомендаций по питанию, потенциально снижающих артериальное давление (АД), таких как ограничение потребления соли, увеличение уровня калия в рационе, потребления клетчатки, полиненасыщенных жирных кислот. Некоторые рекомендации объединяются в диетические паттерны. Одним из таких является вегетарианство. Также есть диеты, показавшие свою эффективность в снижении АД. Среди них средиземноморская, северная, DASH-диета. Цель данного обзора состоит в рассмотрении популярных диетических подходов, снижающих АД, и имеющихся доказательств их эффективности.
Ключевые слова: артериальная гипертония, ожирение, избыточная масса тела, диетические программы, диета.
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Hypertension is one of the most important risk factors of cardiovascular disease. The close relationship of overweight and obesity with high blood pressure is recognized by most experts. Recently, epidemiological studies have seen a steady increase in the frequency of arterial hypertension, which is associated with the pandemic of obesity and its attendant conditions – metabolic syndrome and diabetes. In this regard, it becomes clear that the correction of body weight plays a key role among the modified risk factors. According to the latest recommendations of The American Heart Association and The European Society of Cardiology, all patients with hypertension should follow dietary recommendations. There are a huge number of nutritional recommendations that potentially lower blood pressure. Such as restriction of salt intake, increased level of potassium in the diet, of fiber consumption of polyunsaturated fatty acids. Some of the recommendations are combined into dietary patterns. One of these is vegetarianism. There are also diets that have shown their effectiveness in reducing blood pressure. These include the Mediterranean Diet, the Northern Diet, the DASH Diet. The purpose of this review is to consider the popular dietary approaches that reduce blood pressure and the evidence of their effectiveness.
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NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71: e127–e248.
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1. Kearney PM, Whelton M, Reynolds K et al. Global Burden of Hypertension: Analysis of Worldwide Data. Lancet 2005; 365: 217–23. https://doi.org/10.1016/S0140-6736(05)70151-3
2. Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/
NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71: e127–e248.
3. Czernichow S, Castetbon K, Salanave B et al. Determinants of blood pressure treatment and control in obesepeople: evidence from the general population. J Hypertens 2012; 30 (12): 2338–44. DOI: 10.1097/HJH.0b013e3283593010
4. Lawes CM, Vander Hoorn S, Rodgers A. International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371 (9623): 1513–8. DOI: 10.1016/S0140-6736(08)60655-8
5. Boitsov S.A., Balanova Iu.A., Shal'nova S.A. et al. Arterial'naia gipertoniia sredi lits 25–64 let: rasprostranennost', osvedomlennost', lechenie i kontrol'. Po materialam issledovaniia ESSE. Kardiovaskuliarnaia terapiia i profilaktika. 2014; 4: 4–14 (in Russian).
6. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137 (12): e493. DOI:10.1161/CIR.0000000000000573
7. Kjeldsen SE. Hypertension and cardiovascular risk: General aspects. Pharmacol Res 2018; 129: 95–9. DOI: 10.1016/j.phrs.2017.11.003
8. Vasan RS, Beiser A, Seshadri S et al. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA 2002; 287 (8): 1003–10.
9. Jahangir E, De Schutter A, Lavie CJ. The relationship between obesity and coronary artery disease. Transl Res 2014; 164 (4): 336–44. DOI:10.1016/j.trsl.2014.03.010
10. Finucane MM, Stevens GA, Cowan MJ et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011; 377 (9765): 557–67. DOI: 10.1016/S0140-6736(10)62037-5
11. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014; 311 (8): 806–14. DOI: 10.1001/jama.2014.732
12. Sacks FM, Campos H. Dietary therapy in hypertension. N Engl J Med 2010; 362 (22): 2102–12. DOI: 10.1056/NEJMct0911013
13. Neter JE, Stam BE, Kok FJ et al. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003; 42 (5): 878–84.
14. Stamler J. The INTERSALT Study: background, methods, findings, and implications. Am J Clin Nutr 1997; 65 (Suppl. 2): 626S–642S. DOI: 10.1093/ajcn/65.2.626S
15. Mozaffarian D, Fahimi S, Singh GM et al. Global Burden of Diseases Nutrition and Chronic Diseases Expert Group. Global sodium consumption and death from cardiovascular causes. N Engl J Med 2014; 371 (7): 624–34. DOI: 10.1056/NEJMoa1304127
16. Smith SCJr, Benjamin EJ, Bonow RO et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol 2011; 58 (23): 2432–46. DOI: 10.1016/j.jacc.2011.10.824
17. Eckel RH, Jakicic JM, Ard JD et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63 (25 Pt B): 2960–84. DOI:10.1016/j.jacc.2013.11.003
18. Menotti A, Puddu PE. Coronary heart disease differences across Europe: a contribution from the Seven Countries Study. J Cardiovasc Med (Hagerstown) 2013; 14 (11): 767–72. DOI: 10.2459/JCM.0b013e3283628dff
19. “Dietary surveys in the Zutphen Study”, Seven Countries Study. The first study to relate diet with cardiovascular disease. [Online]. Available: https://www.sevencountriesstudy.com/about-the-study/measurements/dietary-data-in-the-zutphen-study/
20. Appel LJ, Sacks FM, Carey VJ et al. OmniHeart Collaborative Research Group. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 2005; 294 (19): 2455–64.
21. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 2010; 92 (5): 1189–96. DOI: 10.3945/ajcn.2010.29673
22. Nordmann AJ, Suter-Zimmermann K, Bucher HC et al. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med 2011; 124 (9): 841–51.e2. DOI: 10.1016/j.amjmed.2011.04.024
23. Brader L, Uusitupa M, Dragsted LO, Hermansen K. Effects of an isocaloric healthy Nordic diet on ambulatory blood pressure in metabolic syndrome: a randomized SYSDIET sub-study. Eur J Clin Nutr 2014; 68 (1): 57–63. DOI:10.1038/ejcn.2013.192
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Авторы
Ю.В. Жернакова*1, Е.А. Железнова1, И.Е. Чазова1, Н.В. Блинова1, К.П. Иванов1, А.В. Стародубова2
1ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2ФГБУН «Федеральный исследовательский центр питания и биотехнологии», Москва, Россия
*juli001@mail.ru
________________________________________________
Juliya V. Zhernakova*1, Ekaterina A. Zheleznova1, Irina E. Chazova1,
Nataliia V. Blinova1, Konstantin P. Ivanov1, Antonina V. Starodubova2
1National Medical Research Center for Cardiology, Moscow, Russia;
2Federal Research Centre of Nutrition and Biotechnology, Moscow, Russia
*juli001@mail.ru