Cardiovascular and renal hemodynamics and the DASH diet

心血管和肾脏血流动力学以及 DASH 饮食

• 批准号: 6920346
• 负责人: PAUL R CONLIN
• 金额: $ 45.77万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6920346
• 关键词: blood circulation; blood pressure; cardiovascular disorder therapy; clinical research; dairy products; diet therapy; dietary lipid; fruit; heart function; hemodynamics; human subject; hypertension; kidney circulation; kidney function; nutrition related tag; patient oriented research; renin angiotensin system; vascular resistance; vasodilation; vegetables

DESCRIPTION (provided by applicant): This application proposes to expand upon the findings of the DASH study, which showed that a dietary pattern emphasizing fruits, vegetables and low fat dairy products and is overall reduced in total and saturated fat significantly lowers blood pressure (BP). The DASH diet is particularly effective in African Americans and in individuals with systolic hypertension. However, we do not know if the DASH diet affects the pathophysiology of the hypertensive process. Our preliminary data support the possibility that the DASH diet interrupts the renin-angiotensin system. This raises the intriguing possibility that the DASH diet will favorably impact on cardiovascular and renal hemodynamics in patients with isolated systolic hypertension. Therefore, the central hypothesis of this application is that the DASH diet affects central aortic stiffness, diastolic relaxation and renal and vascular reactivity to angiotensin II (Ang II) by lowering tissue renin-angiotensin system activity. We will test this hypothesis in patients with isolated systolic hypertension, by determining if the DASH diet (1) reduces central aortic stiffness, as measured by characteristic impedance (Zc) and carotid-femoral pulse wave velocity (CF-PWV), (2) improves diastolic relaxation, as measured by early diastolic myocardial velocities (Ea), (3) vasodilates renal blood flow and enhances the renal and vascular response to Ang II, and (4) affects these hemodynamic parameters in a manner that is similar to ACE inhibition. We will study 55 participants with isolated systolic hypertension in a randomized, cross-over feeding study of the DASH diet and a control diet. Participants will enter a 2- week run-in period on the control diet followed by two 6-week feeding periods eating the control diet or the DASH diet in random order. After each feeding period, conduit vessel hemodynamic measurements, diastolic relaxation and renal and vascular responses to Ang II will be measured before and after captopril administration. Findings from these studies will determine if the DASH diet favorably affects mechanisms that are altered by the hypertensive process, including renal and cardiac performance, in a group of individuals at higher cardiovascular risk.

描述（由申请人提供）：本申请旨在扩展 DASH 研究的结果，该研究表明，强调水果、蔬菜和低脂乳制品的饮食模式以及总体上减少总脂肪和饱和脂肪的饮食模式可显着降低血压（BP） ）。 DASH 饮食对于非裔美国人和收缩期高血压患者尤其有效。然而，我们不知道 DASH 饮食是否会影响高血压过程的病理生理学。我们的初步数据支持 DASH 饮食中断肾素-血管紧张素系统的可能性。这提出了一种有趣的可能性，即 DASH 饮食将对单纯收缩期高血压患者的心血管和肾脏血流动力学产生有利影响。因此，本申请的中心假设是，DASH饮食通过降低组织肾素-血管紧张素系统活性来影响中央主动脉僵硬度、舒张期舒张以及肾脏和血管对血管紧张素II（Ang II）的反应性。我们将通过确定 DASH 饮食 (1) 是否降低中央主动脉僵硬度（通过特征阻抗 (Zc) 和颈动脉-股动脉脉搏波速度 (CF-PWV) 测量），(2) 在单纯收缩期高血压患者中检验这一假设。改善舒张期舒张（通过早期舒张期心肌速度 (Ea) 测量），(3) 血管舒张肾血流量并增强肾脏和血管对 Ang II 的反应，以及(4) 以类似于 ACE 抑制的方式影响这些血流动力学参数。我们将在一项 DASH 饮食和对照饮食的随机、交叉喂养研究中对 55 名患有单纯收缩期高血压的参与者进行研究。参与者将进入为期 2 周的对照饮食磨合期，然后是两个为期 6 周的喂养期，按随机顺序食用对照饮食或 DASH 饮食。在每个喂养期之后，将在卡托普利给药之前和之后测量导管血管血流动力学测量、舒张舒张以及对Ang II的肾脏和血管反应。这些研究的结果将确定 DASH 饮食是否会对心血管风险较高的人群中因高血压过程而改变的机制产生有利影响，包括肾脏和心脏功能。