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）：本申请提议扩展DASH研究的发现，该研究表明，饮食模式强调水果，蔬菜和低脂乳制品，总体上降低了总脂肪和饱和脂肪，可显着降低血压（BP）。破折号饮食在非裔美国人和收缩压的个体中特别有效。但是，我们不知道破折号饮食是否会影响高血压过程的病理生理。我们的初步数据支持破折号饮食中断肾素 - 血管紧张素系统的可能性。这提出了一种有趣的可能性，即破折号饮食会对分离的收缩压高血压患者的心血管和肾血液动力学有利。因此，该应用的中心假设是，通过降低组织肾素 - 血管紧张素系统活性，破折号饮食会影响中心主动脉僵硬，舒张性松弛以及对血管紧张素II（ANG II）的血管反应性。 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并增强对ANG II的肾脏和血管反应，（4）以类似于ACE抑制的方式影响这些血液动力学参数。我们将研究55名在仪表板饮食和对照饮食的随机，交叉喂养研究中患有分离收缩期高血压的参与者。参与者将在控制饮食中进入2周的跑步期，然后进行两个为期6周的喂养期，以随机顺序吃对照饮食或仪表板饮食。每个进食期后，将在卡托普利给药之前和之后测量导管血液动力学测量，舒张期松弛以及对ANG II的肾脏和血管反应。这些研究的结果将确定仪表板饮食是否有利地影响了一组患有较高心血管风险的个体的高血压过程（包括肾脏和心脏表现）改变的机制。