Effect of Dietary Approaches to Stop Hypertension (DASH) Diet on Heart Failure Status in Older Adults

降血压饮食方法 (DASH) 饮食对老年人心力衰竭状况的影响

基本信息

批准号：
10666118
负责人：
Elisabeth Lilian Pia Sattler
金额：
$ 23.69万
依托单位：
UNIVERSITY OF GEORGIA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10666118
关键词：
Acute Address Aging Biological Markers Blood Pressure Cardiac Cardiology Clinical Clinical Nutrition Clinical Research Clinical Sciences Clinical Trials Congestive Heart Failure Consumption Cross-Over Studies DASH diet Data Development Devices Diagnosis Diastolic blood pressure Diet Dietary Intervention Diuretics EFRAC Early Intervention Edema Elderly Electrolytes Energy Intake Environment Functional disorder Gastrointestinal tract structure Health Care Costs Health Promotion Healthcare Heart Rate Heart failure Home Hospitalization Human Implant Infrastructure Intake Intervention Intervention Studies Knowledge Laboratories Length Malnutrition Modality Monitor Natriuretic Peptides Nutritional Nutritional Support Operative Surgical Procedures Outcome Oxidative Stress Parents Participant Patient Care Patients Pharmaceutical Preparations Pharmacotherapy Phase Physiological Pilot Projects Prevention Prognosis Prognostic Marker Public Health Quality of life Randomized Recommendation Research Research Design Research Project Grants Safety Shortness of Breath Sodium Symptoms Target Populations Therapeutic Translational Research Ventricular Function Visit Weight Gain Woman aged arterial stiffness cardiac cachexia care burden cost design dietary restriction economic cost experience feeding health related quality of life hemodynamics hospital readmission implantable device improved micronutrient deficiency monitoring device mortality novel nutrition older patient patient oriented research preservation pro-brain natriuretic peptide (1-76)programs prospective test pulmonary arterial pressure research clinical testing response telemonitoring treatment as usual trend

项目摘要

PROJECT SUMMARY/ABSTRACT This application is in response to PA-20-194 Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required). While adequate nutrition is known to promote health-related quality of life by addressing malnutrition and promoting optimal functioning among older adults, little is known about the impact of clinical nutrition intervention as a therapeutic modality on heart failure (HF) outcomes. New patient-oriented research on the effects of nutritional therapy on HF status and progression would greatly benefit older HF patients who commonly experience malnutrition. Given the high human and economic costs associated with HF complications among older adults, the development and clinical testing of nutritional standards represents a much needed, low-cost, and prudent strategy likely to improve HF outcomes. This pilot study is designed to prospectively test the effect of a prescribed, laboratory-prepared, home-delivered Dietary Approaches to Stop Hypertension (DASH) diet intervention on clinically important markers of HF status. We will generate important data of the effect of the dietary intervention on pulmonary artery pressures (PAPs) in patients with implanted CardioMEMS™ hemodynamic monitoring device, a novel and groundbreaking approach to the early prediction of acute decompensated HF and effective strategy to reduce rates of HF hospitalizations and mortality. Our target population are older adults aged 65+ years with a diagnosis of HF who are stable on pharmacotherapy. The central hypothesis is that short-term consumption of a DASH diet significantly improves HF status among older patients. We will conduct a randomized crossover clinical study design (n=38, 50% women). Outcomes after 4 weeks on the DASH diet will be compared to a 4-week “own diet” phase during which patients will consume their self-selected, self-prepared diet based on usual care recommendations. Our specific aims are: 1) to determine the effect of consuming a DASH diet for 4 weeks on levels of the natriuretic peptide (NP) biomarkers BNP and NT-ProBNP which are strong prognostic markers in patients with chronic HF; and 2) to examine the effect of consuming a DASH diet for 4 weeks on PAPs in HF patients with implanted CardioMEMS™ device. We anticipate that HF status and PAPs will respond positively and timely to the consumption of a 4-week 2,300 mg sodium-restricted DASH diet intervention. The study is supported by preliminary data demonstrating safety, feasibility, and acceptability of the proposed intervention within the Georgia Clinical and Translational Science Alliance (GA CTSA) infrastructure. In addition, the study team has long-standing experience and expertise in cardiology, pathophysiology, nutrition, public health, and aging related research within the GA CTSA environment and is well suited to carry out the proposed research.

项目概要/摘要本申请是为了响应 PA-20-194 探索性/发展性研究资助计划（父 R21 需要临床试验）。虽然已知充足的营养可以通过以下方式促进健康相关的生活质量。解决老年人的营养不良问题和促进老年人的最佳功能，但对其影响知之甚少临床营养干预作为心力衰竭（HF）结果的新治疗方式。营养治疗对心力衰竭状态和进展影响的研究将极大地有益于老年心力衰竭考虑到与营养不良相关的高昂人力和经济成本。老年人的心力衰竭并发症、营养标准的制定和临床测试代表了这项试点研究旨在采取急需的、低成本且审慎的策略来改善心力衰竭的结果。前瞻性地测试规定的、实验室准备的、家庭提供的戒烟饮食方法的效果高血压 (DASH) 饮食干预对心力衰竭状态的临床重要标志物的影响我们将产生重要的结果。饮食干预对植入患者肺动脉压（PAP）影响的数据 CardioMEMS™ 血流动力学监测设备，一种新颖且突破性的早期预测方法急性失代偿性心力衰竭的治疗方法以及降低心力衰竭住院率和死亡率的有效策略。目标人群是 65 岁以上、诊断为心力衰竭且药物治疗稳定的老年人。中心假设是短期 DASH 饮食可显着改善心力衰竭状态我们将在老年患者中进行一项随机交叉临床研究设计（n=38，50%为女性）。 DASH 饮食 4 周后的结果将与 4 周的“自己饮食”阶段进行比较，在此期间患者将根据我们的常规护理建议自行选择、自行准备饮食。具体目标是： 1) 确定 DASH 饮食 4 周对尿钠水平的影响肽（NP）生物标志物 BNP 和 NT-ProBNP 是慢性病患者的强预后标志物心力衰竭；和 2) 检查 4 周 DASH 饮食对植入心力衰竭患者 PAP 的影响我们预计 HF 状态和 PAP 将对 CardioMEMS™ 设备做出积极、及时的反应。为期 4 周 2,300 毫克钠限制 DASH 饮食干预的支持。初步数据表明拟议干预措施的安全性、可行性和可接受性此外，乔治亚州临床和转化科学联盟（GA CTSA）基础设施。在心脏病学、病理生理学、营养学、公共卫生和衰老方面拥有长期的经验和专业知识 GA CTSA 环境中的相关研究非常适合开展拟议的研究。