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【文摘发布】高血压预防试验观察随访结果:长

RESOURCE: BMJ, doi:10.1136/bmj.39147.604896.55 (published 20 April 2007)

TITLE: Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)

AUTHOR: Nancy R Cook 1*, Jeffrey A Cutler 2, Eva Obarzanek 2, Julie E Buring 1, Kathryn M Rexrode 1, Shiriki K Kumanyika 3, Lawrence J Appel 4, Paul K Whelton 5

1 Brigham and Women's Hospital, Harvard Medical School, Boston, MA
2 National Heart, Lung, and Blood Institute, Bethesda, MD
3 University of Pennsylvania School of Medicine, Philadelphia, PA
4 Johns Hopkins University, Baltimore, MD
5 Loyola University Health System, Maywood, IL

ABSTRACT:
Objective To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II.

Design Long term follow-up assessed 10-15 years after the original trial.

Setting 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone.

Participants Adults aged 30-54 years with prehypertension.

Intervention Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II).

Main outcome measure Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death).

Results 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34).

Conclusion Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events. 本人已认领该文编译,48小时后若未提交译文,请其他战友自由认领。 RESOURCE: BMJ, doi:10.1136/bmj.39147.604896.55 (published 20 April 2007)
文章来源:英国医学杂志doi:10.1136/bmj.39147.604896.55(2007-4-20发表)
TITLE: Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)
标题:高血压预防试验随访观察结果:长期低盐饮食对心血管疾病的影响"
AUTHOR: Nancy R Cook 1*, Jeffrey A Cutler 2, Eva Obarzanek 2, Julie E Buring 1, Kathryn M Rexrode 1, Shiriki K Kumanyika 3, Lawrence J Appel 4, Paul K Whelton 5
作者:Nancy R Cook 1*, Jeffrey A Cutler 2, Eva Obarzanek 2, Julie E Buring 1, Kathryn M Rexrode 1, Shiriki K Kumanyika 3, Lawrence J Appel 4, Paul K Whelton 5
1 Brigham and Women's Hospital, Harvard Medical School, Boston, MA
2 National Heart, Lung, and Blood Institute, Bethesda, MD
3 University of Pennsylvania School of Medicine, Philadelphia, PA
4 Johns Hopkins University, Baltimore, MD
5 Loyola University Health System, Maywood, IL

ABSTRACT:
Objective To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II.
摘要:
目的:为了调查饮食中低钠摄入对于心血管事件的影响,采用TOHP I和 TOHP II两项已完成的随机试验数据。
Design Long term follow-up assessed 10-15 years after the original trial.
计划在最初试验后进行10-15年的长期随访评估。
Setting 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone.
环境;
1987-90年设置10个临床地点(TOHP I),1990-5年设置9个地点(TOHP II)。主要随访通过邮件和电话进行。
Participants Adults aged 30-54 years with prehypertension.
参与者:
年龄为30-54岁有前期高血压的成年人。
Intervention Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II).
干预措施:
减少饮食中的盐量,对低盐摄入进行18个月(TOHP I)或36-48个月(TOHP II)的综合教育和劝告。
Main outcome measure Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death).
主要观察指标:
心血管疾病(心肌梗塞,中风,冠状动脉血运重建术,或心血管性死亡)
Results 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34).

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作者:admin@医学,生命科学    2010-10-28 05:11
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