中国农村地区高血压患者果蔬摄入对血压进展的影响研究

  目的  基于前瞻性队列研究探讨我国农村地区高血压患者果蔬摄入与血压进展的关系。  方法  中国代谢综合征社区干预研究暨中国家庭健康研究于2007-2008年开展基线调查，收集膳食、体力活动和血压等信息，并于2012-2015年进行随访调查。膳食资料采用食物频率问卷获取，按照研究对象总果蔬、水果和蔬菜摄入量是否达到推荐摄入水平和摄入量的四分位数分别进行分组。根据血压水平将高血压分为1级、2级和3级，随访期间高血压分级升高1级及以上则定义为血压进展。采用Logistic回归模型分析果蔬摄入与血压进展的关系。  结果  本研究纳入25 080例基线高血压患者，平均随访5.8年，共有4 112例高血压患者发生血压进展，进展率为16.4%。总果蔬摄入达标者较未达标者血压进展风险降低17%(OR=0.83，95% CI:0.77~0.90)，蔬菜分析结果类似。以总果蔬摄入最低组(Q1)为参照，摄入量位于Q2~Q4组的ORs(95% CIs)值分别为0.86(0.78~0.95)、0.77(0.69~0.86)和0.69(0.61~0.77)(χ2_趋势=43.02, P < 0.001)，水果和蔬菜分析结果相似。总果蔬和蔬菜摄入量每增加100 g/d血压进展风险分别下降4%(OR=0.96，95%CI:0.94~0.98)和5%(OR=0.95，95% CI:0.93~0.97)，而水果与血压进展风险的关联无统计学意义(OR=0.97，95% CI:0.93~1.01)。  结论  增加果蔬摄入能够有效降低血压进展的风险，对高血压患者的健康管理具有积极作用。

Influence of fruit and vegetable consumption on blood pressure progression among hypertensive patients in rural China

Objective To evaluate the relationship of fruit and vegetable consumption with blood pressure(BP)progression among hypertensive patients in rural China,using a prospective cohort study.Methods Baseline examination of the Community Intervention of Metabolic Syndrome in China&Chinese Family Health Study(CIMIC)was conducted in 2007-2008 to collect information on diet consumption,physical activity,BP,and so on.Participants were followed up during 2012-2015.Diet consumption was calculated from food frequency questionnaires.Participants were divided into two groups by whether meeting the recommended intake of total fruit and vegetable(total F&V),fruit,or vegetable consumption(Yes or No),and were also classified into four groups according to their quartiles(Q1-Q4),respectively.Three stages of hypertension were ascertained according to BP levels,and BP progression was defined as an increment of≥1 stage of hypertension from baseline to the follow-up visit.Logistic regression models were used to estimate the odds ratios(ORs)and their corresponding confidence intervals(CIs)for the relationship of fruit and vegetable intake with the risk of BP progression.Results Among 25080 participants with hypertension at baseline,4112 patients had BP progression during the average follow-up of 5.8 years,with the progression rate of 16.4%.Participants who met the recommended total F&V intake had a 17%(OR=0.83,95%CI:0.77-0.90)reduction in the risk of BP progression compared with those who did not.Compared with the lowest group of total F&V consumption(Q1),the ORs(95%CIs)of BP progression were 0.86(0.78-0.95),0.77(0.69-0.86)and 0.69(0.61-0.77)for the Q2,Q3 and Q4 group,respectively(X²_trend=43.02,P<0.001).Analyses of vegetable and fruit consumption showed similar results.Furthermore,each increment of 100 g/d in total F&V and vegetable intake was associated with a 4%(OR=0.96,95%CI:0.94-0.98)and 5%(OR=0.95,95%CI:0.93-0.97)lower risk of BP progression,respectively.The association of fruit with BP progression was not significant(OR=0.97,95%CI:0.93-1.01).Conclusions Increasing the intake of fruit and vegetable could reduce the risk of BP progression and is beneficial for the management of hypertension patients.