고혈압 환자의 식이관련 위험요인 분석에 관한 연구

Dietary Risk Factors Associated with Hypertension in Patients

  • Son, Sook-Mee (Department of Food Science and Nutrition, The Catholic University of Korea) ;
  • Huh, Gwui-Yeop (Department of Nutrition, The Seoul Aewha School)
  • 발행 : 2006.10.31

초록

This study was performed to determine the dietary risk factors associated with hypertension. The hypertensive group were composed of 112 hypertensive patients (male 53, female 59) who first visited the hypertension clinic and had been diagnosed as having primary hypertension ($SBP{\ge}140mmHg\;or\;DBP{\ge}90mmHg$). The regular visitors or the subjects on special diets or medical therapies were excluded. The normal group consisted of as subjects (male 41, female 54) matched with age and socioeconomic levels. The subjects having higher intakes (above the 75 percentile) in energy, protein, iron, vitamin A or C showed significantly higher hypertension risk estimated with odds ratio after the covariance factors (age, sex and BMI) were adjusted. More than 2400 mg of sodium (6 g of salt) intake was associated with significantly higher risk of hypertension (odds ratio: 1.773, CI: 1.014-3.014 for $SBP{\ge}140mmHg$; odds ratio: 2.373, CI: 1.359-4.215 for $DBP{\ge}90mmHg$). Hypertensive group showed significantly increased intakes of vegetables and fish and shell fish compared to the normal group. When the vegetable intakes were classified into Kimchi, fresh vegetables and cooked vegetables with seasoning, the hypertensive group was observed as having higher intakes of Kimchi and cooked vegetables with seasoning. The intakes of highest quartile for vegetables (${\ge}327g/day$) (odds ratio: 3.164, CI: 1.740-5.752), fish and their products (${\ge}102g/day$) (odds ratio: 2.756, CI: 1.486-5.109), grains(${\ge}311g/day$) (odds ratio 2.393, CI: 1.186-4.832), meats and their product (${\ge}106g$) (odds ratio: 2.210, CI: 1.225 - 3.987) compared to the lower were significantly associated with the higher risk of hypertension estimated with DBP (${\ge}90mmHg$) after covariance factors were adjusted. In conclusion, our findings confirm that higher intake of energy or sodium are associated with the increased risk of hypertension. Because increased intake of vegetable or fish was associated with the higher risk of hypertension, in contrast with the finding of western countries, choosing or preparation of vegetables or fish with reduced salt is recommended.

키워드

참고문헌

  1. 구재옥. 이연숙.손숙미. 서정숙(2003) : 식사요법. 한국방송통신대학교 출판부
  2. 김영희. 김진복. 유윤희. 허계영(1999) : 병을 이기는 식사법.pp.31-40. 서울문화사, 서울
  3. 통계청(2002) : 2001년 사망원인 통계연보
  4. Alonso A, Fuente C, Martin-Arnau AM, Irala J, Martinez JA, Martinez-Gonzalez MA (2004): Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento. Universidad de Navarra (SUN) Study. British J Nutr 92:311-319 https://doi.org/10.1079/BJN20041196
  5. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks PM (2006): Dietary approaches to prevent and treat hypertension: A scientific statement from the American Heart Association. Hypertension 47: 296-308 https://doi.org/10.1161/01.HYP.0000202568.01167.B6
  6. Ascherio A, Rimm EB, Stampfer MJ, Giovannucci EL, Willett WC (1996): Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. ACC Current Journal Review 5(3):39
  7. Cappuccio FP, Elliott P, Allender PS, Pryer J, Follman PA, Culter JA (1995) : Epidemiologic association between dietary calcium intake and blood pressure:a meta-analysis of published data. Am J Epidemiol 142:935-945 https://doi.org/10.1093/oxfordjournals.aje.a117741
  8. Choi MK, Lee WY, Park JD (2005): Relation among mineral (Ca, P, Fe, Na, K, Zn) intakes, blood pressure, and blood lipids in Korean adults. Korean J Nutr 38(10): 827-835
  9. Djousse L, Folson AR, Province MA, Hunt SC, Ellison RC (2003): Dietary linolenic acid and carotid atherosclerosis: the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 77: 819-825 https://doi.org/10.1093/ajcn/77.4.819
  10. He FJ, Macgregor GA (2002): Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials: implications for public health. J Hum Hypertension 16:761-770 https://doi.org/10.1038/sj.jhh.1001459
  11. He J, Whelton PK (1999): Effect of dietary fiber and protein intake on blood pressure: a review of epidemiologic evidence. Clin Exp Hypertens 21:785-796 https://doi.org/10.3109/10641969909061008
  12. Huh GY, Son SM (2004): Risk factors of hypertension and development of FFQ and nutrition education program. 2004 Symposium of the Korean Society of Community Nutrition. Proceedings pp.109-111
  13. Jee SH, Miller ER 3rd, Guallar E, Singh VK, Appel LJ, Klag MJ (2002): The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens 15:691-696 https://doi.org/10.1016/S0895-7061(02)02964-3
  14. Joint National Committee (1997): The sixth report of the joint National Committee on detection, evaluation, and treatment of high blood pressure. Arch Intern Med 157:2413-2446 https://doi.org/10.1001/archinte.157.21.2413
  15. Karanja NM, Obarzanek E, Lim PH, McCullough ML, Phillips KM, Swan IF, Champagne CM, Hobern KP (1999): Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension Trial: DASH collaborative research group. J Am Diet Assoc 99:519-527
  16. Kim SK (2003): Lifestyle and chronic disease-A cohort study on the risk factors for hypertension and NIDDM in Korea. Korean J Comm Nutr 8(6):1010-1020
  17. Klatsky AL, Friedman GD, Siegelaub AB, Gerard MJ (1997): Alcohol consumption and blood pressure. Kaiser-Permanente. Multiphasic Health Examination data. N Eng J Med 296:1194-1200 https://doi.org/10.1056/NEJM197705262962103
  18. Lee JW, La HS, Kwak CS (1996): Dietary factors and serum urinary electrolytes affecting blood pressure in adolescents. Korean J Comm Nutr 1(1):61-70
  19. Ministry of Health and Welfare/Korea Institute of Health and Social Affairs/Korea Health Industry Development Institute (MOH/KHIDI) (2002):2001 National Health and Nutrition Survey Report
  20. Mizushima S, Cappuccio FP, Nichols R, Elliott P (1998): Dietary magnesium intake and blood pressure: a qualitative overview of the observational studies. J Hum Hypertens 12:447-453 https://doi.org/10.1038/sj.jhh.1000641
  21. Moon HK, Joung H (1999): Dietary risk factors of hypertension in the elderly. Korean J Nutrition 32(1):90-100
  22. Morris MC (1994): Dietary fats and blood pressure. J Cardiovasc Risk 1:21-30 https://doi.org/10.1097/00043798-199406000-00005
  23. Morris RC Jr, Sebastian A, Forman A, Tanaka M, Schmidlin O (1999): Normotensive salt sensitivity: effect of race and dietary potassium. Hypertension 33:18-23 https://doi.org/10.1161/01.HYP.33.1.18
  24. Okuto Y, Miyamoto T, Suwazono Y, Kobayasi E, Nogawa K (2001): Alcohol consumption and blood pressure in Japanese men. Alcohol 23:149-156 https://doi.org/10.1016/S0741-8329(01)00131-8
  25. Paik HY (1987): Nutritional aspects for salt proceedings of the Korean Society of Food and Cookery Science Conference. pp.92-106
  26. Park JA, Yoon JS (2001): The effect of habitual calcium and sodium intakes on blood pressure regulating hormone in free-living hypertensive women. Korean J Nutr 34(4):409-416
  27. Reed D, Mcgee D, Yano K, Hankin J (1985): Diet, blood pressure and multicollinearity. Hypertension 7:405-410
  28. Sacks FM, Rosner B, Kass EH (1974): Blood pressure in vegetarians. Am J Epidemiol 100:390-398 https://doi.org/10.1093/oxfordjournals.aje.a112050
  29. Saito K, Sano H, Frunta Y, Fukuzaki H (1989): Effect of oral calcium on blood pressure reponse in salt-loaded borderline hypertensive patients. Hypertension 13:219-226 https://doi.org/10.1161/01.HYP.13.3.219
  30. Son EJ, Moon HK (2002): The relationship of nutritional status to the degree of hypertension in residents of Kangbuk-gu, Seoul. Korean J Comm Nutrition 7(3): 304-315
  31. Son SM, Jeong YS (2005): Blood pressure and life styles according to sodium intake and recommended sodium intake in Korean adults. 2005 International Symposium and Annual Meeting of the Korean Society of Food Science and Nutrition, Proceedings pp.452
  32. Son SM, Huh KY (2002): Salt intake and nutritional problems in Korean. Korean J Comm Nutr 7(3):381-390
  33. Stamler J, Applegate WB, Cohen JD, Cutler JA, Whelton PK (1997): More on dietary sodium and blood pressure. JAMA [NLM-MED-LINE] 277(20):1594
  34. Stamler J, Caggiula H, Grandits GA, Kjelsberg M, Culter JA (1996): Relationship to blood pressure of combinations of dietary macronutrients: findings of the Multiple Risk Factor Intervention Trial (MRFIT). Circulation 94:2417-2423 https://doi.org/10.1161/01.CIR.94.10.2417
  35. Whelton PK (1994): Epidemiology of hypertension. The Lancet 344:101-106 https://doi.org/10.1016/S0140-6736(94)91285-8
  36. Whelton PK, He J, Culler JA, Brancati FL, Appel LJ, Follman D, Klag MJ (1997): Effect of oral potassium on blood pressure: meta-analysis of randomized controlled clinical trials. JAMA 277: 1624-1632 https://doi.org/10.1001/jama.277.20.1624
  37. Whelton PK, He J, Appel LJ, Culter JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, BInston Mc, Karimkabas J (2002): Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 288:1582-1888
  38. Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK (2001) : Effect of alcohol reduction on blood pressure: a metaanalysis of randomized controlled trials. Hypertension 38: 1112-1117 https://doi.org/10.1161/hy1101.093424