人群膳食结构干预对血压均值的影响

Effects of dietary pattern modification on blood pressure over in a work site intervention program

观察对心血管病危险因素进行人群干预的可行性和有效性。方法自１９８７～１９９５年在北京一个钢铁公司，选二个分厂分别为加强干预厂和一般干预厂（对照），对职工进行卫生宣教与健康促进，指导食堂炊事员及采购员对食品的选择与烹调。在研究开始与结束时分别在二个厂抽样进行３天２４小时膳食调查。结果干预结果表明，加强干预厂膳食中钠盐由１６克降至１０．６克（Ｐ＜０．０５），包括高血压患者在内干预厂平均收缩压下降５．３ｍｍＨｇ（１ｍｍＨｇ＝０．１３３ｋＰａ），舒张压下降２．９ｍｍＨｇ，Ｐ＜０．０１。两厂正常血压人群相比，加强干预厂较一般干预厂收缩压净下降３．４ｍｍ Ｈｇ，舒张压净下降１．９ｍｍ Ｈｇ，Ｐ＜０．０１。结论通过改善膳食结构特别是限盐来控制人群血压升高，不仅是可行的、而且是有效的。

Objective The CISCIP is a work site intervention program in Capital Iron and Steel Companyof Beijing, China, aimed at evaluating the feasibility and effects of hypertension prevention and control on bloodpressure in a long-term. To assess the effectsd of health education and dietary pattern modification, includingreducting fat and cholesterol intake and particularly restricting salt consumption, on blood pressure at the work sitelevel. Methods Blood pressures were obtained from 662 males in the Intervention factories (IF) and 542 malesin Comparison factories (CF) in 1987 and from 1176 males in IF and 1014 males in CF respectively in 1995.Dietary advice was provided to the staff in IF. Dietary data were collected according to a standardized 24-hourdietary recall procedure in 3 consecutive days. Results Mean of daily salt intake reduced from 16.0 g/day to10.6 g/day (33.7% reduction, P<0.05)in IF, and from 16.9 g/day to 15.4 g/day (8.9% reduction, P>0.05) in CF over 8 years. Meanwhile, blood pressure of normotensives in IF also decreased signifcantly more thanthat in CF (net-reduction of SBP:2.5mm Hg, P<0.05; and DBP: 2.2mm Hg, P<0.01 for IF versus CF).Conclusion Dietary pattern modification, specifically restricting salt consumption in males is one of the effectivemeasures for hypertension prevention and control at the work site level.