Dietary Intakes Consistent with the DASH Dietary Pattern Reduce Blood Pressure Increase with Age and Risk for Stroke in a Chinese Population

遵循DASH飲食型態降低隨年齡而上升的血壓和中風風險

Pao-Hwa Lin ； Wen-Ting Yeh ； Laura P. Svetkey ； Shao-Yuan Chuang ； Yuan-Chin Chang ； Christine Wang ； Wen-Harn Pan

《Asia Pacific Journal of Clinical Nutrition》 22卷3期 (2013/08) Pp. 482-491

https://doi.org/10.6133/apjcn.2013.22.3.05

摘要

DASH飲食型態（Dietary Approaches to Stop Hypertension）已在非亞裔人群中被證實能有效降低血壓，並且能減低心血管疾病和腦中風的機率。然而，目前的研究對於遵循DASH飲食型態所建議的食物群或遵循DASH營養素是否能達到相似的降血壓效果尚無結論。本課题分别研究在1420和2061位台灣成人裏，從1989到2002年間，有關DASH飲食型態的食物群或營養素的依從度與血壓和中風機率的相關性。依據單一回歸分析，DASH食物評分（p=0.053），乳製品（p=0.030）和鈣質（p=0.020）的攝取顯著地和追踪的收缩壓呈負相關。在多元回歸分析裏，乳製品（p=0.020）和鈣質（p=0.001）也一致地與收缩壓呈現顯著的負相關。没有任何一種食物或營養素與舒張壓呈顯著關係。DASH營養素評分和鎂的攝取與總中風機率呈顯著的負相關。以DASH營養素評分而言，與最低的DASH營養素評分三分位組別相比，最高組的總中風的風險比率是0.63（95%CI：0.41－0.98；p=0.037），而對鎂攝取量而言則是0.62（95% CI：0.40－0.97；p=0.030）。DASH營養素評分（p=0.011）和鎂攝取（p=0.043）與缺血性中風也有類似的關係。總中風和缺血性中風與鈣攝取亦呈现邊際的顯著關係（p值各為0.071和0.051）。總之，對這個華人族羣而言，依從DASH飲食型態有助於長期血壓控制和降低中風的機率。

關鍵字

飲食型態 ； 飲食 ； 血壓 ； 高血壓 ； 中風

並列摘要

The Dietary Approaches to Stop Hypertension (DASH) diet has been proven to effectively lower blood pressure (BP), and associate with a lower cardiovascular disease and stroke risk in mainly non-Asians. Further, it is unclear if adhering to the DASH target nutrients has similar BP impact as adhering to the recommended DASH food groups. Associations between adherence to DASH foods or nutrients and BP or stroke risk were assessed in 1420 and 2061 Taiwanese adults from 1989 to 2002, respectively. The DASH food score (p=0.053), dairy (p=0.030) and calcium (p=0.020) intake were significantly and inversely associated with follow up systolic BP change in univariate analyses. Both dairy (p=0.020) and calcium (p=0.001) also showed a consistent inverse association with systolic BP change in multivariate analysis. None of the factors examined was associated with diastolic BP change. Both DASH nutrient score and magnesium intakes were significantly associated with the hazard ratio (HR) for total stroke in an inverse relationship. The HR of total stroke comparing the highest to the lowest tertile was 0.63 (95% CI: 0.41-0.98, p=0.037) for the DASH nutrient score, and 0.62 (95% CI: 0.40-0.97, p=0.030) for magnesium intake. Similar findings were observed for DASH nutrient score (p=0.011) and magnesium intake (p=0.043) with the HR for ischemic stroke. The HR for total and ischemic stroke for calcium intake also showed a borderline trend (p=0.071 and 0.051, respectively). In conclusion, adhering to the DASH diet is beneficial for long term BP control and reduction of stroke risk in this Chinese population.

並列關鍵字

dietary pattern ； diet ； blood pressure ； hypertension ； stroke

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