高动物蛋白饮食对高血压患者血管功能及心血管危险因素的影响

The effects of high-protein diet on vascular function and cardiovascular risk factors in patient with hypertension

目的了解高动物蛋白饮食对血管功能和颈动脉内膜中层厚度等心血管危险因素的影响。方法在广东省人民医院心血管门诊选取符合纳入标准的高血压患者88例,通过问卷调查方式获取参与者的一般生活方式,检测肱动脉血流介导的血管舒张功能(FMD)和肱踝脉搏波传导速度,同时收集患者颈动脉内膜中层厚度(IMT)等一般临床资料,分析高动物蛋白饮食与血管功能及颈动脉内膜中层厚度等心血管危险因素的相关性。结果男性52例,女性36例,中位年龄42(38,53)岁。平均动脉压中位数106(97,112)mmHg,最高平均动脉压中位数123(116,132)mmHg。FMD中位数5.1(3.8,7.3)%,IMT中位数0.9(0.8,1.2)mm。在日常饮食中,偏向于高动物蛋白饮食的39例,比较均衡的36例;高动物蛋白饮食与FMD显著负相关,与IMT显著正相关;而且,动物蛋白摄入量较大的受试者倾向于存在更大的心血管风险。结论高血压患者在接受有效降压治疗的同时,应采取健康的生活方式,均衡饮食,避免过高的动物蛋白摄入量,可能有助于降低心血管疾病风险。

Objective To explore the effects of high-protein diet on vascular function and cardiovascular risk factors in patient with hypertension. Methods A total of 88 patients with hypertension were enrolled and the information on self-reported lifestyle and dietary behaviors were collected via survey questionnaire;the flowmediated dilation(FMD) and brachial-ankle pulse wave velocity were detected, then the general clinical data such as carotid intima-media thickness(IMT) were collected. The correlational analyses were conducted by evaluate the effects of high-protein diet on vascular function and cardiovascular risk factors. Results Of the patients, 59.1%(52/88) were male and 40.9%(36/88) were female and the median age was 42(38-53) years. The median mean arterial pressure was 106(97-112) mmHg and the highest mean arterial pressure was 123(116, 132) mmHg. The median FMD was 5.1(3.8, 7.3)% and the median IMT was 0.9(0.8, 1.2) mm. In the daily diet, 44.3%(39/88) of the subjects preferred to a high-protein diet and 40.9%(36/88) had a balanced diet. Higher animal protein intake was inversely associated with FMD and positively associated with IMT. Furthermore, individuals consumed a high-protein diet tended to have higher cardiovascular risk. Conclusion In addition to effective antihypertensive treatment, a healthy lifestyle including balanced diet should be recommended for hypertensive patients, which may help to reduce the cardiovascular risk.