高血压患者的医学营养治疗

高血压与膳食因素密切相关,近年来的前瞻性研究证实,除遗传因素外,超重和肥胖、过量饮酒、高钠摄入、低钾膳食、低钙膳食等是高血压的危险膳食营养因素。现就高钠饮食及肥胖对高血压的危险性及饮食治疗作一浅谈。     

新疆“塔克拉玛干沙漠人”高血压与摄盐量、摄钠量相关性研究

目的:探讨新疆塔克拉玛干沙漠人高血压与摄盐量、摄钠量的相关性.方法:应用WHO MONICA方案.采取随机抽样的方法.对508名≥16岁塔克拉玛干"沙漠人"进行高血压流行病学调查,运用24 h膳食同顾法进行膳食营养调查.将≥30岁282名"沙漠人"与随机抽取新疆和田于田县≥30岁成年人151名进行对照分析.结果:两组间膳食中摄盐量、摄钠量进行比较均有显著差异(P<0.001).进行二分类非条件性Logistic逐步回归法分析结果为:膳食中摄盐量、摄钠量为≥30岁沙漠人组高血压的危险因素,其中膳食中摄盐量OR=1.724,钠OR=1.002.膳食中摄钠量为≥30岁于田组高血压的危险因素,其OR=1.001.结论:"沙漠人"以食用土盐为主,膳食中钠的摄入量偏低,摄盐量、摄钠量是高血压的危险因素,处于低盐环境的人群高血压检出率低,减少摄盐量可预防高血压及减少发病率.     

新乡县农村居民高血压患者膳食结构及相关因素调查

目的：探讨农村居民高血压及其相关危险因素,为高血压的预防和膳食指导提供依据.方法：对新乡县农村居民进行健康及营养状况和食物频率问卷调查、体格检查,采用SPSS 10.0统计软件从一般情况、体质指数（BMI）、生活方式、膳食摄入等方面进行多因素Logistic回归分析,分析农村居民的生活方式和膳食摄入状况与高血压的关系.结果：进入Logistic回归模型的相关因素中,年龄、被动吸烟和BMI与高血压的发生呈正相关;膳食因素中薯类和新鲜蔬菜与高血压的发生呈负相关.结论：合理膳食及健康生活方式是防治高血压的主要措施.     

柳州市郊居民高血压患病危险因素调查

目的为了解柳州市郊区居民中高血压患病率及其危险因素.方法采用问卷方法调查柳州市郊区2242名居民的高血压患病率及其危险因素.结果高血压患病率为23.15%;高血压患病率与居民的年龄、性别、民族、职业以及钠盐摄入、高脂饮食等因素关系密切.结论培养居民良好的生活习惯和合理的膳食制度是防治高血压病的重要措施之一.     

盂县地区高血压患病危险因素分析

目的 :探讨高血压患病的危险因素。方法 :对盂县地区 35～ 5 9岁农民采用整群随机抽样的方法调查 4 4 5 8人。结果 :高血压患病率女性高于男性 ,χ2 =2 5 15P <0 0 1,男女高血压患病率有非常显著意义 ;高血压患病率随体重指数升高而增高 ,男性 χ2 =5 4 .30P <0 0 1女性 χ2 =5 7 37P <0 0 1具有非常显著意义 ;膳食特点 :每人每日公斤体重钠摄入量偏高而钾、钙偏低 ,钠 /钾比值女性明显高于男性 ,男性 2 35∶1、女性 2 5 5∶1;高血压患病率随胆固醇水平升高而增高 ,高胆固醇组、正常胆固醇组均高于低胆固醇组 ,男性 χ2 =12 .76P <0 0 1、女性 χ2 =14 5 1P <0 0 1具有非常显著意义 ,女性胆固醇水平均高于男性。结论 :超体重、肥胖、高胆固醇、高钠低钾低钙膳食是高血压发生的主要危险因素。     

中国膳食平衡指数在慢性病因素分析中的应用研究

目的建立中国膳食平衡指数与慢性病因素分析相结合的关联分析方法,为改善人群营养和健康状况、制定相关政策和疾病防治措施提供科学依据。方法对邯郸市邯山区6个居委会、180户家庭进行3 d 24 h膳食回顾和全家调味品称重调查,同时进行血压、血糖和血脂检测。结果对调查人群的膳食与营养相关性数据进行多因素logistic回归分析,证实鱼虾和食用油的摄入都是高血压的危险因素(OR=1.015、1.014,P0.05);盐的摄入是血脂异常的危险因素(OR=1.065,P0.05)。去除膳食平衡指数最优模式人群,对膳食不足与膳食过量的人群进行多因素logistic回归分析,证实鱼虾和食用油、畜禽肉类及盐的摄入分别是高血压、糖尿病和血脂异常的危险因素(OR=1.012、1.049、1.005、1.066,P0.05)。结论当地居民慢性病的危险因素是高盐、高脂等不健康饮食,同时验证了膳食平衡指数评价后的慢性病因素分析方法的科学、灵敏与适用性。     

梅河口市5912名村民高血压致病因素抽样调查

目的 了解梅河口市农村人口高血压致病因素.方法 抽样调查六个乡的六个村的15岁以上居民,共调查5912人,1724户.结果 15岁以上村民吸烟人数占70%,高盐膳食居民达100%,超量摄入食用油者占96%,过多摄入蛋类者占57%.结论 我市农村人口高血压致病因素中突出的是:吸烟行为、高盐膳食、超量的食用油摄入、过量的蛋类摄入.其它高血压致病因素与之并存.     

开封市企业职工高血压与膳食结构、BMI等相关因素关系研究

目的了解开封市企业职工高血压与膳食结构、BMI等相关因素的关系,为企业职工高血压膳食干预提供依据。方法采取整群抽样的方法抽取20家企业4 656名职工作为研究对象,测量其身高、体重及血压,使用统一问卷调查职工一般情况及过去一年膳食摄入情况,采用多因素Logistic回归分析高血压与相关因素的关系。结果职工高血压患病率17.1%,肥胖率12.7%,多因素Logistic回归显示家族史(OR=2.231,95%CI=1.914~2.503)、高食盐摄入量(OR=1.373,95%CI=1.213~1.701)、饮酒(OR=1.361,95%CI=1.201~1.873)和体重超重(OR=2.365,95%CI=1.925~3.269)肥胖(OR=2.961,95%CI=2.201~4.103)是高血压病的危险因素。结论企业职工高血压发病率较高,膳食因素、家族史、超重肥胖对高血压有较大影响。     

膳食平衡是防治原发性高血压病的基础

近年来,随着人们饮食习惯的变化,生活节奏加快,原发性高血压发病率逐年升高,这种疾病的危险因素除了年龄与遗传外,与膳食关系也较为密切。膳食结构不合理、过度摄入能量及高盐饮食可增加原发性高血压疾病的发病风险。本文主要对平衡膳食在防治原发性高血压病的作用进行了研究和分析,探讨适合我国人民发展实际的平衡膳食模式。     

青年人高血压及其影响因素的研究

目的探讨青年人高血压的患病情况及其主要的危险因素.方法从2004年7月至12月广西地区糖尿病普查的资料中抽取有完整的个人基本情况、血压、血脂、血糖等资料的20～40岁人群共3 385人列入本次分析.结果在3 385名青年人中,高血压患者237人,高血压患病率为7.0%,男性为9.6%,女性为4.0%.腹型肥胖、酒龄、高甘油三酯血症是高血压主要的危险因素,其OR值及95%可信区间分别为3.207（1.686～6.102）、2.305（1.275～4.165）、1.984（1.078～3.650）.结论腹型肥胖、酒龄、高甘油三酯血症是广西青年人高血压主要的危险因素,在青年人中开展健康教育、提倡合理膳食、适当运动十分必要.     

Effects of exposure to salty drinking water in an Arizona community. Cardiovascular mortality, hypertension prevalence, and relationships between blood pressure and sodium intake

A high level of sodium (440 mg/L) in the water supply of Gila Bend, Ariz, caused concern because of apparently elevated rates of hypertension in Gila Bend Papago Indians. We surveyed 342 Gila Bend Papago Indians and 375 non-Indians from July to September 1983. Participants 25 years of age and older were interviewed for health risk factors, water consumption, and dietary sodium and calcium intake and had height, weight, blood pressure, and urinary sodium and potassium levels measured. No consistent associations were found between any of the sodium values and systolic or diastolic blood pressure. Mean blood pressures for the Gila Bend whites were lower in most age groups than in comparison US white populations. The prevalence rates of hypertension in Gila Bend were not significantly higher than national rates.     

Prevalence of hypertension among Chinese elderly and its relationship to behavioural and nutritional factors

A cross-sectional study was carried out to determine the prevalence of hypertension in the Chinese elderly and to examine its relationship with various behavioural and nutritional risk factors. This study involved 243 Chinese aged 55 years and older in 2 randomly selected Chinese Villages in Seberang Prai Tengah, Penang. The study included an interview, anthropometric assessment and blood pressure measurement. The prevalence of hypertension was 48.1% and out of this, 65 (55.6%) were on anti-hypertensive treatment. There was a significant rise in the prevalence with age. Hypertension was found to be inversely related to per capita income and physical activity (p < 0.05). Hypertension was significantly more common in smokers than non-smokers. Alcohol intake in the elderly was low and not related to hypertension. Obesity was significantly associated with hypertension only among the elderly aged 55-64 years. The dietary intake of sodium, potassium and calcium did not differ significantly between the hypertensive and normotensive elderly.     

某县区成年居民高血压患病率及其影响因素调查

目的了解铜陵县（现义安区）成年居民高血压患病情况及其影响因素。方法采取多阶段整群随机抽样的方法,共问卷调查该区13个乡镇2 091户3 221名成年居民,了解其一般情况、高血压患病情况及影响因素,并测量血压、身高、体质量、腰围等指标。结果铜陵县成年居民高血压患病率为33.9%,性别间差异无统计学意义（P > 0.05）;不同职业及是否参加锻炼的居民间高血压患病率差异均无统计学意义（P > 0.05）;不同年龄、体质量指数、文化程度、腰围、吸烟、饮酒、口味、每日摄入新鲜蔬菜、每日摄入新鲜水果及腌熏肉类频次者高血压患病率差异有统计学意义（P < 0.05~P < 0.01）。经logistic回归分析发现,较高的受教育程度、口味适中、每日摄入适量的蔬菜及偶尔进食腌熏肉类是高血压的保护因素;而年龄、BMI和戒烟是高血压的危险因素。结论义安区成年居民高血压患病率较高,应加强居民高血压防控知识的宣传,形成良好的行为和饮食习惯,全面防治高血压的发生。     

The circadian rhythm of blood pressure and the effect of sa lt intake in salt-sensitive subjects

Objective To investigate the effect of salt intake on the circadian rhythm of blood pressure and the characteristics of ambulatory blood pressure (ABP) in salt-sensitive (SS) subjects. Methods Twenty-three normotensive subjects and forty-three patients with essential hypertension were included in this study.Salt sensitivity was determined with a chronic dietary salt loading test and an acute venous saline loading test, respectively.24-hour ABP measurements were performed twice in normotensive subjects when they were on a high salt diet and when they had a low salt diet.Blood and urine samples were collected for measurement of plasma norepinephrine concentration (PNE), plasma renin activity (PRA), angiotensin Ⅱ, aldosterone, erythrocyte sodium content and urinary sodium excretion.24-hour ABP readings were also obtained in patients with essential hypertension when antihypertensive drugs were discontinued for at least 2 weeks. Results High salt intake attenuated the circadian rhythm of blood pressure in SS normotensive subjects, and the nocturnal decline in blood pressure was smaller in SS patients with essential hypertension than in salt-resistant (SR) patients.The level of PNE was higher and the suppression of PRA was smaller in SS subjects than in SR subjects when they had a high salt diet, and the urinary sodium excretion decreased and the erythrocyte sodium content increased significantly in SS subjects on high salt intake. Conclusions High salt intake caused an abnormal circadian rhythm of blood pressure in SS subjects.The blunted nocturnal decline in blood pressure may be a characteristics of SS patients with essential hypertension.     

膳食钠盐、体质量指数与良性前列腺增生关系的研究

目的 探讨老年男性膳食钠盐、体质量指数(BMI)与良性前列腺增生(BPH)危险性之间的关系.方法 采取以医院为基础的病例对照研究.研究组由经组织学检查证实患BPH的男性患者组成,对照组由因患其他疾病入住与研究组患者相同医院的同期患者组成.研究组与对照组各360例,1∶1匹配.采用标准调查表对全部研究对象进行问卷调查,同...     

北京市东城区社区糖尿病患者冠心病患病状况及影响因素研究

背景　我国糖尿病和冠心病的患病率均呈逐年上升趋势,而糖尿病患者常合并冠心病,在社区层面针对多个危险因素开展综合性干预是降低和减缓慢性病发展进程的有效措施。但目前糖尿病患者合并冠心病的患病状况及其影响因素的研究较少,且相关的行为因素有待进一步明确。目的　通过分析北京市东城区社区糖尿病人群的冠心病患病情况,探讨社区糖尿病患者并发冠心病的相关行为因素,为进一步开展社区糖尿病合并冠心病患者的防治提供科学依据。方法　于2018年6月-2019年5月,收集东城区社区卫生服务平台系统2014年记录的9 260例糖尿病患者的数据资料,分析人群的冠心病患病率及分布特征,根据是否患有冠心病将糖尿病患者分为非冠心病组和冠心病组,比较两组年龄、性别、超重或肥胖情况、高血压病史及生活行为习惯的不同。采用Logistic逐步回归分析糖尿病患者发生冠心病的影响因素。结果　2014年北京市东城区社区糖尿病患者合并冠心病的发生率为49.13%（4 549/9 260）,膳食合理者占5.27%（488/9 260）,体力活动综合分级为较多者占9.49%（879/9 260）。超重或肥胖、高血压病史、平均每天主食量、平均每天吃水果量、每日饮水量、体力活动综合分级不同的糖尿病患者冠心病发生率不同,差异有统计学意义（P<0.05）。Logistic逐步回归分析结果显示,年龄、性别、有无高血压病史、平均每天吃水果量、体力活动综合分级是糖尿病患者发生冠心病的影响因素（P<0.05）。结论　北京市东城区社区糖尿病管理人群的冠心病患病率较高,该人群中饮食习惯和生活方式不合理比例较高,年龄大、女性、有高血压病史是糖尿病患者发生冠心病的可能危险因素,平均每天吃水果量大、体力活动综合分级高为糖尿病患者发生冠心病的保护因素。     

Diet and calcium stones.

OBJECTIVE: To review the current literature on the dietary modification of urinary risk factors as a means of reducing the likelihood of recurrent stone formation and to develop practical dietary recommendations that might be useful to this end. DATA SOURCES: MEDLINE was searched for English-language articles published from 1983 to 1990. Additional references were selected from the bibliographies of identified articles. STUDY SELECTION: Nonrandomized trials and retrospective reviews were included because of a paucity of randomized controlled trials. DATA SYNTHESIS: Information on the dietary intake of calcium, oxalate, protein, sodium and fibre and on alcohol and fluid intake was used to develop practical guidelines on dietary modification. CONCLUSION: Dietary modification plays an important role in the reduction of urinary risk factors in patients with calcium stone disease of the urinary tract. As an initial form of prevention attention should be directed toward moderating the intake of calcium, oxalate, protein, sodium and alcohol and increasing the intake of fibre and water. Future research should include an assessment of the long-term reduction of dietary and urinary risk factors and the rates of recurrence of calcium stones.     

广西田东县农村壮族居民高血压抽样调查

目的了解广西田东县农村壮族居民高血压患病情况及其相关影响因素。方法采用整群随机抽样法对21 985名≥18岁农村壮族居民进行血压、年龄、性别、婚姻、吸烟、饮酒、血压知晓及治疗情况调查,并进行统计学分析。结果田东县农村壮族居民高血压标化患病率为13.70%,男性15.37%,女性11.90%,男性居民高血压患病率高于女性（P〈0.01）。农村壮族居民高血压标化患病率明显低于2002年全国调查的18.8%,高血压的知晓率、治疗率及控制率均低于全国水平。结论 广西田东县农村壮族居民高血压的患病率低于年全国水平,患病率与年龄、吸烟、饮酒因素呈正相关。     

广西农村居民慢性肾脏病流行病学调查

目的:了解广西农村居民慢性肾脏病(CKD)流行情况及危险因素,为做好CKD防治工作提供有力依据。方法:采用分层多级随机抽样方法,对广西18～74岁农村居民进行CKD抽样调查。被调查者均接受问卷调查,检测尿白蛋白/肌酐比率、血尿(离心后尿沉渣显微镜检查)和肾脏B超,结果异常者3个月后进行复查。用国人校正的简化MDRD公式计算估计肾小球滤过率(eGFR)。同时调查了CKD的相关危险因素。结果:广西农村居民白蛋白尿患病率5.35%,血尿患病率0.97%,肾结石患病率10.73%,肾功能下降率4.08%,CKD患病率9.47%。农村居民CKD危险因素依次肾结石、高血压、糖尿病、年龄、高尿酸血症、慢性扁桃体炎和HBsAg阳性。居民CKD知晓率6.27%。结论:农村居民CKD发病率分别为9.47%,居民CKD知晓率,CKD相关危险因素肾结石、高血压、糖尿病、年龄、高尿酸血症、慢性扁桃体炎和HBsAg阳性。     

Blood pressure control during weight reduction in obese hypertensive men: separate effects of sodium and energy restriction

The separate and combined effects of dietary energy and sodium restriction on regulation of blood pressure were investigated in 30 middle aged obese men with essential hypertension attending the outpatient department. In group 1 (n = 15) a basal period with no dietary restriction was followed by a period taking an energy reduced diet (5.1 MJ; 1230 kcal), the sodium intake being supplemented and hence unchanged (1:ErSn). In group 2 (n = 15) the basal period preceded a control period with no intervention, which was followed by taking a diet restricted in energy (5.1 MJ; 1220 kcal) and sodium (2:ErSr). During period 1:ErSn there were reductions in heart rate and urinary noradrenaline output but not in systolic or diastolic blood pressure. Body weight decreased by 4.9-11.7 kg and urinary sodium excretion did not change. In period 2:ErSr urinary sodium output was reduced by 81.4 (SEM 17.8) mmol(mEq)/24 h and there was a weight loss of 8.2 (SEM 0.7) kg. Systolic and diastolic blood pressures fell significantly, as did the heart rate and urinary noradrenaline excretion. These results show that in hypertensive obese men a moderate weight reducing diet decreases indices of sympathetic nervous system activity. Reduction of blood pressure to the normotensive range was observed only when there was a concomitant restriction of sodium intake.