Nejvíce citovaný článek - PubMed ID 11136953
Western-type diet with high salt and sugar, sedentary behavior, obesity, tobacco and alcoholism are important risk factors for hypertension. This review aims to highlight the role of western diet-induced oxidative stress and inflammation in the pathogenesis of hypertension and the role of various types of diets in its prevention with reference to dietary approaches to stop hypertension (DASH) diet. It seems that it is crucial to alter the western type of diet because such diets can also predispose all CVDs. Western diet-induced oxidative stress is characterized by excessive production of reactive oxygen species (ROS) with an altered oxidation-reduction (redox) state, leading to a marked increase in inflammation and vascular dysfunction. Apart from genetic and environmental factors, one important cause for differences in the prevalence of hypertension in various countries may be diet quality, deficiency in functional foods, and salt consumption. The role of the DASH diet has been established. However, there are gaps in knowledge about the role of some Indo-Mediterranean foods and Japanese foods, which have been found to decrease blood pressure (BP) by improving vascular function. The notable Indo-Mediterranean foods are pulses, porridge, spices, and millets; fruits such as guava and blackberry and vegetables, which may also decrease BPs. The Japanese diet consists of soya tofu, whole rice, in particular medical rice, vegetables and plenty of fish rich in fish oil, fish peptides and taurine that are known to decrease BPs. Epidemiological studies and randomized, controlled trials have demonstrated the role of these diets in the prevention of hypertension and metabolic diseases. Such evidence is still meager from Japan, although the prevalence of hypertension is lower (15-21%) compared to other developed countries, which may be due to the high quality of the Japanese diet. Interestingly, some foods, such as berries, guava, pumpkin seeds, carrots, soya beans, and spices, have been found to cause a decrease in BPs. Omega-3 fatty acids, fish peptide, taurine, dietary vitamin D, vitamin C, potassium, magnesium, flavonoids, nitrate and l-arginine are potential nutrients that can also decrease BPs. Larger cohort studies and controlled trials are necessary to confirm our views.
- Klíčová slova
- Mediterranean diet, anti-inflammatory foods, high blood pressure, western diet,
- MeSH
- DASH dieta * MeSH
- dieta MeSH
- hypertenze * epidemiologie prevence a kontrola MeSH
- krevní tlak MeSH
- ovoce MeSH
- randomizované kontrolované studie jako téma MeSH
- vitaminy MeSH
- zelenina MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- vitaminy MeSH
High-salt diets are a major cause of hypertension and cardiovascular (CV) disease. Many governments are interested in using food salt reduction programs to reduce the risk for salt-induced increases in blood pressure and CV events. It is assumed that reducing the salt concentration of processed foods will substantially reduce mean salt intake in the general population. However, contrary to expectations, reducing the sodium density of nearly all foods consumed in England by 21% had little or no effect on salt intake in the general population. This may be due to the fact that in England, as in other countries including the U.S.A., mean salt intake is already close to the lower normal physiologic limit for mean salt intake of free-living populations. Thus, mechanism-based strategies for preventing salt-induced increases in blood pressure that do not solely depend on reducing salt intake merit attention. It is now recognized that the initiation of salt-induced increases in blood pressure often involves a combination of normal increases in sodium balance, blood volume and cardiac output together with abnormal vascular resistance responses to increased salt intake. Therefore, preventing either the normal increases in sodium balance and cardiac output, or the abnormal vascular resistance responses to salt, can prevent salt-induced increases in blood pressure. Suboptimal nutrient intake is a common cause of the hemodynamic disturbances mediating salt-induced hypertension. Accordingly, efforts to identify and correct the nutrient deficiencies that promote salt sensitivity hold promise for decreasing population risk of salt-induced hypertension without requiring reductions in salt intake.
- Klíčová slova
- blood pressure, hypertension, nitrate, salt, sodium, sodium chloride,
- MeSH
- hypertenze * chemicky indukované prevence a kontrola MeSH
- kardiovaskulární nemoci * MeSH
- krevní tlak MeSH
- kuchyňská sůl škodlivé účinky MeSH
- lidé MeSH
- sodík MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- kuchyňská sůl MeSH
- sodík MeSH
- MeSH
- chlorid sodný MeSH
- kuchyňská sůl * MeSH
- stravovací zvyklosti * MeSH
- Úřad Spojených států pro potraviny a léky MeSH
- Publikační typ
- práce podpořená grantem MeSH
- úvodníky MeSH
- Geografické názvy
- Spojené státy americké MeSH
- Názvy látek
- chlorid sodný MeSH
- kuchyňská sůl * MeSH
On average, black individuals are widely believed to be more sensitive than white individuals to blood pressure (BP) effects of changes in salt intake. However, few studies have directly compared the BP effects of changing salt intake in black versus white individuals. In this narrative review, we analyze those studies and note that when potassium intake substantially exceeds the recently recommended US dietary goal of 87 mmol/day, black adults do not appear more sensitive than white adults to BP effects of short-term or long-term increases in salt intake (from an intake ≤50 mmol/day up to 150 mmol/day or more). However, with lower potassium intakes, racial differences in salt sensitivity are observed. Mechanistic studies suggest that racial differences in salt sensitivity are related to differences in vascular resistance responses to changes in salt intake mediated by vasodilator and vasoconstrictor pathways. With respect to cause and prevention of racial disparities in salt sensitivity, it is noteworthy that 1) on average, black individuals consume less potassium than white individuals and 2) consuming supplemental potassium bicarbonate, or potassium rich foods can prevent racial disparities in salt sensitivity. However, the new US dietary guidelines reduced the dietary potassium goal well below the amount associated with preventing racial disparities in salt sensitivity. These observations should motivate research on the impact of the new dietary potassium guidelines on racial disparities in salt sensitivity, the risks and benefits of potassium-containing salt substitutes or supplements, and methods for increasing consumption of foods rich in nutrients that protect against salt-induced hypertension.
- Klíčová slova
- hypertension, nitrate, race, salt-sensitive, sodium,
- MeSH
- běloši MeSH
- černoši MeSH
- draslík dietní * MeSH
- hypertenze patofyziologie MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- rizikové faktory MeSH
- sodík dietní * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- draslík dietní * MeSH
- sodík dietní * MeSH
The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2-3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.
- Klíčová slova
- arterial pressure, caffeine, disease prevention, hypertension, resistance training,
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
To reduce the risk of salt-induced hypertension, medical authorities have emphasized dietary guidelines promoting high intakes of potassium and low intakes of salt that provide molar ratios of potassium to salt of ≥1:1. However, during the past several decades, relatively few people have changed their eating habits sufficiently to reach the recommended dietary goals for salt and potassium. Thus, new strategies that reduce the risk of salt-induced hypertension without requiring major changes in dietary habits would be of considerable medical interest. In the current studies in a widely used model of salt-induced hypertension, the Dahl salt-sensitive rat, we found that supplemental dietary sodium nitrate confers substantial protection from initiation of salt-induced hypertension when the molar ratio of added nitrate to added salt is only ≈1:170. Provision of a low molar ratio of added nitrate to added salt of ≈1:110 by supplementing the diet with beetroot also conferred substantial protection against salt-induced increases in blood pressure. The results suggest that on a molar basis and a weight basis, dietary nitrate may be ≈100× more potent than dietary potassium with respect to providing substantial resistance to the pressor effects of increased salt intake. Given that leafy green and root vegetables contain large amounts of inorganic nitrate, these findings raise the possibility that fortification of salty food products with small amounts of a nitrate-rich vegetable concentrate may provide a simple method for reducing risk for salt-induced hypertension.
- Klíčová slova
- diet, hypertension, nitric oxide, rats, sodium,
- MeSH
- Beta vulgaris * MeSH
- chlorid sodný toxicita MeSH
- dieta metody MeSH
- dusičnany aplikace a dávkování MeSH
- hypertenze chemicky indukované patofyziologie prevence a kontrola MeSH
- krevní tlak fyziologie MeSH
- krysa rodu Rattus MeSH
- modely nemocí na zvířatech MeSH
- potkani inbrední Dahl MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- chlorid sodný MeSH
- dusičnany MeSH
BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) dietary pattern, which emphasizes fruit, vegetables, fat-free/low-fat dairy, whole grains, nuts and legumes, and limits saturated fat, cholesterol, red and processed meats, sweets, added sugars, salt and sugar-sweetened beverages, is widely recommended by international diabetes and heart association guidelines. OBJECTIVE: To summarize the available evidence for the update of the European Association of the Study of Diabetes (EASD) guidelines, we conducted an umbrella review of existing systematic reviews and meta-analyses using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach of the relation of the DASH dietary pattern with cardiovascular disease and other cardiometabolic outcomes in prospective cohort studies and its effect on blood pressure and other cardiometabolic risk factors in controlled trials in individuals with and without diabetes. METHODS: MEDLINE and EMBASE were searched through 3 January 2019. We included systematic reviews and meta-analyses assessing the relation of the DASH dietary pattern with cardiometabolic disease outcomes in prospective cohort studies and the effect on cardiometabolic risk factors in randomized and non-randomized controlled trials. Two independent reviewers extracted relevant data and assessed the risk of bias of individual studies. The primary outcome was incident cardiovascular disease (CVD) in the prospective cohort studies and systolic blood pressure in the controlled trials. Secondary outcomes included incident coronary heart disease, stroke, and diabetes in prospective cohort studies and other established cardiometabolic risk factors in controlled trials. If the search did not identify an existing systematic review and meta-analysis on a pre-specified outcome, then we conducted our own systematic review and meta-analysis. The evidence was summarized as risk ratios (RR) for disease incidence outcomes and mean differences (MDs) for risk factor outcomes with 95% confidence intervals (95% CIs). The certainty of the evidence was assessed using GRADE. RESULTS: We identified three systematic reviews and meta-analyses of 15 unique prospective cohort studies (n = 942,140) and four systematic reviews and meta-analyses of 31 unique controlled trials (n = 4,414) across outcomes. We conducted our own systematic review and meta-analysis of 2 controlled trials (n = 65) for HbA1c. The DASH dietary pattern was associated with decreased incident cardiovascular disease (RR, 0.80 (0.76⁻0.85)), coronary heart disease (0.79 (0.71⁻0.88)), stroke (0.81 (0.72⁻0.92)), and diabetes (0.82 (0.74⁻0.92)) in prospective cohort studies and decreased systolic (MD, -5.2 mmHg (95% CI, -7.0 to -3.4)) and diastolic (-2.60 mmHg (-3.50 to -1.70)) blood pressure, Total-C (-0.20 mmol/L (-0.31 to -0.10)), LDL-C (-0.10 mmol/L (-0.20 to -0.01)), HbA1c (-0.53% (-0.62, -0.43)), fasting blood insulin (-0.15 μU/mL (-0.22 to -0.08)), and body weight (-1.42 kg (-2.03 to -0.82)) in controlled trials. There was no effect on HDL-C, triglycerides, fasting blood glucose, HOMA-IR, or CRP. The certainty of the evidence was moderate for SBP and low for CVD incidence and ranged from very low to moderate for the secondary outcomes. CONCLUSIONS: Current evidence allows for the conclusion that the DASH dietary pattern is associated with decreased incidence of cardiovascular disease and improves blood pressure with evidence of other cardiometabolic advantages in people with and without diabetes. More research is needed to improve the certainty of the estimates.
- Klíčová slova
- DASH, GRADE, cardiometabolic health, cardiovascular disease, dietary approaches to stop hypertension, review,
- MeSH
- DASH dieta * MeSH
- hypertenze dietoterapie prevence a kontrola MeSH
- kardiovaskulární nemoci prevence a kontrola MeSH
- lidé MeSH
- metaanalýza jako téma MeSH
- metabolické nemoci prevence a kontrola MeSH
- systematický přehled jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Cardiovascular diseases constitute one of the main causes of disability and premature death. The basic pathology consists of atherosclerosis. Therefore, influencing risk factors, including nutrition, is essential for prevention. AIM: To assess the opinion of Czech citizens, over 40 years old, on the role of nutrition as it relates to risk factors for cardiovascular diseases. METHODS: Data from 1992 participants were acquired using a research questionnaire administered throughout the Czech Republic from 1.4.2016-20.4.2016. The data was analyzed using the SASD program, version 1.4.12. RESULTS: Data analyses revealed that the age group in question still includes a great number of people who are unaware of the relationship between nutrition and development (31.8%) or progression (18.0%) of heart diseases. Rejection of the relationship was most frequently expressed by those 40-49 years of age and those that were employed. The study also found that the role of nutrition modification was more frequently discussed between patients and physicians (54.7%) than patients and nurses (38.0%). An overwhelming majority of respondents considered information related to nutrition modification useful (93.0%). CONCLUSION: In order to increase the efficiency of preventive measures, the transfer of theoretical knowledge to the lay public must be accompanied by interventions aimed at information repetition, motivation, and establishment of partnerships with health care providers.
- Klíčová slova
- Cardiovascular diseases, Nurse, Nutrition habits, Prevention, Risk factor,
- MeSH
- chování snižující riziko * MeSH
- dospělí MeSH
- kardiovaskulární nemoci diagnóza enzymologie patofyziologie prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- nutriční hodnota MeSH
- nutriční stav MeSH
- ochranné faktory MeSH
- podpora zdraví MeSH
- prognóza MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stravovací zvyklosti MeSH
- věkové faktory MeSH
- zdravá strava * MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
High salt intake is one of the major dietary determinants of hypertension and cardiovascular disease in Japan and throughout the world. Although dietary salt restriction may be of clinical benefit in salt-sensitive individuals, many individuals may not wish, or be able to, reduce their intake of salt. Thus, identification of functional foods that can help protect against mechanistic abnormalities mediating salt-induced hypertension is an issue of considerable medical and scientific interest. According to the "vasodysfunction" theory of salt-induced hypertension, the hemodynamic abnormality initiating salt-induced increases in blood pressure usually involves subnormal vasodilation and abnormally increased vascular resistance in response to increased salt intake. Because disturbances in nitric oxide activity can contribute to subnormal vasodilator responses to increased salt intake that often mediate blood pressure salt sensitivity, increased intake of functional foods that support nitric oxide activity may help to reduce the risk for salt-induced hypertension. Mounting evidence indicates that increased consumption of traditional Japanese vegetables and other vegetables with high nitrate content such as table beets and kale can promote the formation of nitric oxide through an endothelial independent pathway that involves reduction of dietary nitrate to nitrite and nitric oxide. In addition, recent studies in animal models have demonstrated that modest increases in nitrate intake can protect against the initiation of salt-induced hypertension. These observations are: (1) consistent with the view that increased intake of many traditional Japanese vegetables and other nitrate rich vegetables, and of functional foods derived from such vegetables, may help maintain healthy blood pressure despite a high salt diet; (2) support government recommendations to increase vegetable intake in the Japanese population.
- Klíčová slova
- Hypertension, Nitrate, Salt, Salt sensitivity, Sodium,
- MeSH
- funkční potraviny * MeSH
- hypertenze prevence a kontrola MeSH
- kardiovaskulární nemoci prevence a kontrola MeSH
- kuchyňská sůl škodlivé účinky MeSH
- lidé MeSH
- oxid dusnatý metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Japonsko MeSH
- Názvy látek
- kuchyňská sůl MeSH
- oxid dusnatý MeSH
Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with an increased risk of cardiovascular disease (CVD). Fewer than half of those with hypertension are aware of their condition, and many others are aware but not treated or inadequately treated, although successful treatment of hypertension reduces the global burden of disease and mortality. The aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition. The evaluation of patients with hypertension includes accurate standardized blood pressure (BP) measurement, assessment of the patients' predicted risk of atherosclerotic CVD and evidence of target-organ damage, and detection of secondary causes of hypertension and presence of comorbidities (such as CVD and kidney disease). Lifestyle changes, including dietary modifications and increased physical activity, are effective in lowering BP and preventing hypertension and its CVD sequelae. Pharmacological therapy is very effective in lowering BP and in preventing CVD outcomes in most patients; first-line antihypertensive medications include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, dihydropyridine calcium-channel blockers and thiazide diuretics.
- MeSH
- antihypertenziva farmakokinetika terapeutické užití MeSH
- blokátory kalciových kanálů terapeutické užití MeSH
- diuretika terapeutické užití MeSH
- hypertenze komplikace epidemiologie patofyziologie MeSH
- kardiovaskulární nemoci etiologie patofyziologie MeSH
- kvalita života MeSH
- lidé MeSH
- renin-angiotensin systém účinky léků MeSH
- sympatický nervový systém účinky léků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- antihypertenziva MeSH
- blokátory kalciových kanálů MeSH
- diuretika MeSH