EFFECT OF DIETARY COUNSELING ON BLOOD-PRESSURE AND ARTERIAL PLASMA-CATECHOLAMINES IN PRIMARY HYPERTENSION

被引:41
作者
BECKMANN, SL [1 ]
OS, I [1 ]
KJELDSEN, SE [1 ]
EIDE, IK [1 ]
WESTHEIM, AS [1 ]
HJERMANN, I [1 ]
机构
[1] UNIV OSLO,ULLEVAAL HOSP,DEPT INTERNAL MED,N-0407 OSLO,NORWAY
关键词
EPINEPHRINE; HYPERTENSION; NOREPINEPHRINE; SODIUM; SYMPATHETIC NERVOUS SYSTEM;
D O I
10.1016/0895-7061(95)00122-6
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
There is still a need of support for nonpharmacologic treatment of uncomplicated, mild-to-moderate essential hypertension. We investigated whether a low sodium-based diet implemented by a nutritionist could lower blood pressure and affect sympathetic activity. Middle-aged, otherwise healthy men with never-treated essential hypertension (n = 95) were randomized to an intervention group, a blood pressure control group, and a time control group. The intervention group was advised to use less sodium chloride in their diet, and if necessary, less saturated fat and decrease body weight. They attended regular clinic visits as did the blood pressure control group. After 1 year, the intervention group had achieved on average 72 mmol/24 h lower urinary sodium excretion (P <.001) and a decrease in body weight of 2.7 +/- 0.5 kg (P <.001). Both supine and standing mean blood pressure were on average 8 to 10 mm Hg lower after intervention compared with the two control groups (P <.001). Arterial plasma epinephrine, measured in all 40-year-old subjects (n = 30), decreased in parallel in all three groups (P <.05), indicating some habituation to the invasive procedure and clinic visits. However, the decrease in norepinephrine was significant (P <.001) only in the intervention group; it correlated with the weight loss (r = 0.76, P <.05) and was significantly higher (P <.05) than in both control groups. These results suggest that broad dietary advice (ie, low intake of sodium chloride, saturated fat and energy), implemented by a nutritionist, may have a significant blood pressure lowering effect and a favorable sympathicolytic effect in uncomplicated, mild-to-moderate essential hypertension.
引用
收藏
页码:704 / 711
页数:8
相关论文
共 40 条
[1]  
The fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V), Arch Intern Med, 153, pp. 154-183, (1993)
[2]  
1993 Guidelines for the management of mild hypertension: Memorandum from a World Health Organization/International Society of Hypertension meeting, J Hypertens, 11, pp. 905-918, (1993)
[3]  
Sever P., Beevers G., Bulpitt C., Et al., Management guidelines in essential hypertension: Report of the second working party of the British Hypertension Society, Br Med J, 306, pp. 983-987, (1993)
[4]  
Reisin E., Abel R., Modan M., Et al., Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients, N Engl J Med, 298, pp. 1-310, (1981)
[5]  
MacGregor G.A., Markandu N.D., Best F.E., Et al., Doubleblind randomized crossover trial of moderate sodium restriction in essential hypertension, Lancet, 1, pp. 351-355, (1982)
[6]  
MacGregor G.A., Smith S.J., Markandu N.D., Et al., Moderate potassium supplementation in essential hypertension, Lancet, 2, pp. 567-570, (1982)
[7]  
Stamler R., Stamler J., Gosch F.C., Et al., Primary prevention of hypertension by nutritional-hygienic means: Final report of a randomized, controlled trial, JAMA, 262, pp. 1801-1807, (1989)
[8]  
Bonaa K.H., Bjerve K.S., Straume B., Et al., Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension, N Engl J Med, 322, pp. 795-801, (1990)
[9]  
Neaton J.D., Grimm R.H., Prineas R.J., Et al., Treatment of mild hypertension study. Final results, JAMA, 270, pp. 713-724, (1993)
[10]  
Kjeldsen S.E., Flaaten B., Eide I., Et al., Evidence of increased peripheral catecholamine release in patients with long-standing, untreated essential hypertension, Scand J Clin Lab Invest, 42, pp. 217-223, (1982)