摘要
目的 评价高血压防治指南中的膳食指南,比较不同指南推荐膳食的异同及规律,探讨膳食对防治高血压的作用,促进对指南的理解,探索饮食干预高血压的最佳方法。方法 计算机检索CNKI、EMbase、Pub Med等中英文数据库和指南网站,查找高血压防治指南中的膳食指南,检索时限均为从建库自2014年2月28日。采用指南评价工具（AGREEⅡ）评价纳入指南的方法学质量,并通过同类比较分析不同地区和质量级别指南所推荐膳食的特点。结果 共纳入来自5大洲9个国家、2个地区（台湾和欧洲）和1个组织（WHO）的27篇高血压膳食干预指南。采用AGREEⅡ对其进行评价结果显示,该27篇指南中A级（推荐）13篇,B级（不同程度修改完善后推荐）14篇;除“制定的严谨性”和“适用性”两个领域分别为（57.89±7.71）%和（58.39±6.29）%外,其余均为≥60%。各膳食指南均提倡低钠饮食,目前一般为5～6 g/d,但大洋洲提出4 g/d,北美洲提出随年龄增加摄入量减少;酒精量男性一般为30 m L/d,女性一般为20 m L/d,不同地区略有差异;水果、蔬菜及钾摄入量各洲均要求增加。结论 目前不同国家或地区膳食干预高血压指南的质量半数以上尚需进行完善及修改。膳食推荐存在地区差异,且与性别、年龄有关。
Objective To review guidelines on diet intervention for hypertension, compare the similarities/ differences and the regularity of the guidelines, discuss the prevention and treatment effects of diet intervention for hypertension, promote the understanding of the guide, and to explore the best method of diet intervention for hypertension. Methods Database such as CNKI, EMbase, PubMed, etc., as well as guideline websites were searched from inception to February 28th, 2014, for collecting guidelines on diet intervention in the prevention and treatment of hypertension. The Appraisal of Guidelines for Research and Evaluation （AGREE II） were applied to assess methodological quality of the guidelines. Characteristics of diets recommended by the guidelines were analyzed through comparing the different regions and quality levels of the guidelines. Results A total of 27 guidelines on diet intervention for hypertension were included. They were formulated by 5 continents, 9 countries, 2 regions （Taiwan of China and Europe）, and 1 international organization （WHO）. According to the AGREE II instrument, 13 guidelines were graded as Level A （recommendation） and 14 were graded as Level B （recommended after changes）, respectively. The domains were more than 60% except for ＂rigor of development＂ （57.89±7.71） % and ＂applicability＂ （58.39±6.29） %. Each guideline recommended low sodium diet （usually： 5 to 6 g/d; Oceania： 4 g/d; North America： the amount of sodium intake should be decreased as age increases）. The amount of alcohol intake was generally 30 mL/d for men and 20 mL/d for women. All included guidelines recommended to increase the intake of fruits, vegetables, and potassium. Conclusion Currently, more than half of diet intervention recommendations for hypertension in different countries and regions are still needs to be improved and modified. Diet recommendations differ in regions, gender, and age.
出处
《中国循证医学杂志》
CSCD
2015年第1期36-46,共11页
Chinese Journal of Evidence-based Medicine
