Effets à Court Terme d’un Régime DASH sur les Profils Cliniques et Anthropométriques d’un Groupe d’Hypertendus

M. Olivier Pancha, Florence Fouejeu T, Olivier Ngoufack T. J., Richard M Nguimbou

Abstract


RÉSUMÉ
Introduction. Les mesures hygiéno-diététiques constituent un volet important de la prise en charge de l’hypertension artérielle. L’objectif de ce travail était d’évaluer l’effet d’un régime «Dietary Approches to Stop Hypertension» (DASH) administré à des patients hypertendus non traités. Matériels et méthodes. Un essai non randomisé à un bras a été réalisé à l’Unité de prise en charge du diabète et de l’hypertension artérielle de l’Hôpital Régional de Ngaoundéré au Cameroun. L’intervention consistait en l’administration pendant une durée de 08 semaines d’un régime DASH en environnement autonome couplé à la pratique d’une activité physique régulière. Ce régime était riche en fruits, légumes et  produits laitiers, modérément riche en protéines et pauvre en matière grasse. Durant l’intervention, les paramètres anthropométriques, cliniques et biologiques étaient mesurés chez les participants. Résultats. Un total de 36 patients a été inclus dans l’étude. Les données obtenues ont montré une diminution significative des valeurs moyennes de l’indice de masse corporelle (-3,82 kg/m2; p = 0,001), du tour de taille (-7,9 cm; p = 0,001), du taux de cholestérol-LDL, (- 0,49 g/L; p = 0,001), de la pression artérielle systolique (-40 mmHg ; p = 0,001) et de la pression artérielle diastolique (18 mmHg, p = 0,001) chez les participants. Conclusion. L’observance à court terme d’un régime de type DASH améliore les indicateurs de risque cardiovasculaire chez les sujets hypertendus dans notre environnement.

ABSTRACT
Purpose. Diet and life style modifications constitute and important part of the management of hypertension. The aim of this study was to evaluate the effect of the DASH eating plan in untreated hypertensive patients. Materials and methods. A single-arm non-randomized trial was conducted at the Diabetes and Hypertension Unit of the Ngaoundere Regional Hospital in Cameroon. The intervention was a non-controlled and self-directed DASH eating plan followed by participants, associated with a regular physical activity during a 08 weeks period. Anthropometric, clinical and biological parameters were measured in all participants at the beginning and at the end of the intervention. Results. A total of 36 patients were included. The results showed a significant decrease in mean values of body mass index (-3.82 kg/m2, p = 0.001), waist circumference (-7.9 cm, p = 0.001), LDL cholesterol (- 0.49 g/L, p = 0.001), systolic blood pressure (-40 mmHg, p = 0.001) and diastolic blood pressure (18 mmHg,  p = 0.001), suggesting an improvement in cardiovascular risk indicators in the study participants. Conclusion. Short-term adherence to a DASH-type diet improves cardiovascular risk indicators in hypertensive subjects in our environment.

Keywords


Pression artérielle, Hypertension artérielle, Régime DASH

Full Text:

PDF (Français)

References


Kearney PM, Whelton M, Reynolds K et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005, 365, 217–237.

WHO. A global brief on hypertension: silent killer, global public health crisis. World Health Day, 2013.

Ewane ME, Mandengue SH, Priso EB et al. Dépistage des maladies cardiovasculaires chez des étudiants de l’Université de Douala et influence des activités physiques et sportives. Pan African Medical Journal 2012, 11 (1), 77.

Appel LJ, Moore TJ, Obarzanek E et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative Research Group. N Engl J Med, 1997, 336 (16), 1117-24.

Blumenthal JA, Babyak MA, Hinderliter A et al. Effects of the DASH Diet Alone and in Combination With Exercise and Weight Loss on Blood Pressure and Cardiovascular Biomarkers in Men and Women With High Blood Pressure. The ENCORE Study. Arch Intern Med, 2010, 170 (2), 126-135.

Utsugi MT, Ohkubo T, Kikuya M et al. Fruit and vegetable consumption and the risk of hypertension determined by self-measurement of blood pressure at home: the Ohasama study. Hypertens Res, 2008, 31 (7), 1435-43.

Lichtenstein AH, Appel LJ, Brands M et al. Diet and lifestyle recommendations revision 2006. A scientific statement from the American Heart Association nutrition committee. Circulation, 2006, 114 (1), 82–96.

Sheps SG, Black HR, Cohen JD et al. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda: National Institute of Health, 1997, Publication No. 98-4080.

Tchuenguem F F-N, Fameni T S, Mbianda A P, Messi J, Brückner D. Foraging behaviour of Apis mellifera adansonii Latreille (Hymenoptera : Apidae) on Daniellia oliveri, Delonix regia, Hymenocardia acida and Terminalia mantaly flowers in Ngaoundéré (Cameroon). Int J Biol Chem Sci, 2010, 4(4), 1180-1190.

OMS. Le Manuel de Surveillance STEPS de l'OMS: L'approche STEPwise de l'OMS pour la surveillance des facteurs de risque des maladies chroniques. Genève, Organisation Mondiale de la Santé, 2005.

Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. Your guide to Lowering Your Blood Pressure with DASH. NIH Publication No. 06-4082, 2006.

Siqueira-Catania A, Cezaretto A, Risso de Barros C et al. Cardiometabolic risk reduction through lifestyle intervention programs in the Brazilian public health system. Diabetol Metab Syndr, 2013, 5(1), 21.

Mujica V, Urzua A, Leiva E et al. Intervention with education and exercise reverses the metabolic syndrome in adults. J Am Soc Hypertens, 2010, 4 (3), 148-53.

Nakanishi N, Makino K, Nishina K et al. Relationship of light to moderate alcohol consumption and risk of hypertension in Japanese male office workers. Alcohol Clin Exp Res 2002, 26, 988–94.

Yoshita K, Miura K, Morikawa Y et al. Relationship of alcohol consumption to7-year blood pressure change in Japanese men. J Hypertens, 2005, 23, 1485-90.

Husain K, Ansari RA, Ferder L. Alcohol-induced hypertension: Mechanism and prevention. World J Cardiol, 2014, 6(5), 245-252.

Zhang WS, Xu L, Schooling CM, et al. Effect of alcohol and aldehyde dehydrogenase gene polymorphisms on alcohol-associated hypertension: the Guangzhou Biobank Cohort Study. Hypertens Res, 2013, 36(8), 741-6.

Drummond W, Shrager H. Ethanol induced dose-dependent vasoconstriction in unanesthetized lambs. Exp Lung Res, 1985, 9, 341-349.

Fitts DA, Hoon RG. Ethanol-induced changes in plasma proteins, angiotensin II, and salt appetite in rats. Behav Neurosci, 1993, 107, 339-345.

Husain K. Vascular endothelial oxidative stress in alcohol-induced hypertension. Cell Mol Biol, 2007, 53, 70-77.

Hsieh ST, Sano H, Saito K, Kubota Y, Yokoyama M. Magnesium supplementation prevents the development of alcohol-induced hypertension. Hypertension, 1992, 19,175-182.

Madika A-L, Mounier-Vehier C. Tabac et pression artérielle : une relation complexe à mieux connaître. La Presse Médicale, 2017, 46 (7–8), 697-702.

Mc Donnell BJ, Maki-Petaja KM, Munnery M, et al. Habitual exercise and blood pressure: age dependency and underlying mechanisms. Am J Hypertens, 2013, 26 (3): 334-41,

WHO. The SHAKE Technical Package for Salt Reduction. Geneva, World Health Organization, 2016.

Descaillot L, Lavile M. Actualité du sodium dans les maladies rénales et cardiovasculaires. Néphrol ther, 2015.

Takase H, Sugiura T, Kimura G et al. Dietary Sodium Consumption Predicts Future Blood Pressure and Incident Hypertension in the Japanese Normotensive General Population. J Am Heart Assoc, 2015, 4, e001959.

Farquhar WB, Edwards DG, Jurkovitz CT et al. Dietary Sodium and Health: More than Just Blood Pressure. J Am Coll Cardiol, 2015, 65(10), 1042-1050.

Bando M, Fujiwara I, Imamura Y et al. Lifestyle Habits Adjustment for Hypertension and Discontinuation of Antihypertensive Agents. J Hypertens, 2018, 7: 248.

Langford H, Cushman W et Hsu H. Chronic effect of KCl on black-white differences in plasma renin activity, aldosterone, and urinary electrolytes. Am J Hypertens 2000; 4:399-403.

Franceschini S, Priore S et Euclydes M. Necessidades et recommandations de nutrientes. Dans: Cupari L. Guias de medicina ambulatoire et hospitalar. 2ª ed. SãoPaulo: Manole, UNIFESP/Escola Paulista de Medicina, 2002.

Daviset M, Jones D. Le rôle de la gestion du mode de vie dans le plan global de traitement pour la prévention et la gestion de l'hypertension. Semin Nephrol, 2002, 35(2), 35-43.

Dessein PH, Shipton EA, Stanwix AE et al. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis, 2000, 59(7), 539-43.

Hotamisligil GS. Inflammation et troubles métaboliques. Nature, 2006, 444 (7121), 860-7.

De Simone G, Mancini M, Mainenti G et al. Weight reduction lowers blood pressure I ndependently of salt restriction. J Endocrinol Invest, 1992, 15(5), 339-43.

Grossman E, Eshkol A, Rosenthai1 T. Diet and weight loss: their effect on norepinephrine renin and aldosterone levels. Int J Obesity, 1985, 9, 107.

Gonias SL et Campanayz WM. LDL Receptor Related Protein-1. A Regulator of Inflammation in Atherosclerosis, Cancer, and Injury to the Nervous System. Am J Pathol, 2014, 184 (18), e27.

Jellinger PS, Handelsman Y, Rosenblit et al. American association of clinical endocrinologists and american college of endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract, 2017, Suppl 2 (23), 1-87.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

********************************************************************************************