Abstract：
BACKGROUND: High fruit and vegetable diets are associated with reduced chronic kidney disease and cardiovascular disease but are infrequently used in hypertension treatment. Low acid diets are also associated with reduced chronic kidney disease and cardiovascular disease, and fruits and vegetables or oral sodium bicarbonate (NaHCO3) lowers dietary acid.
METHODS: We randomized 153 hypertensive macroalbuminuric patients receiving pharmacologic chronic kidney disease and cardiovascular disease protection to get fruits and vegetables, oral NaHCO3, or Usual Care. We assessed the course of kidney disease progression and cardiovascular disease risk indices over five years.
RESULTS: Chronic kidney disease progression was slower in participants receiving fruits and vegetables or oral NaHCO3 than Usual Care [mean (SE)] [-1.08 (0.06) and -1.17 (0.07) vs. -1.94 (0.11) mL/min/1.73m2/ year, respectively, P\'s< .001). Yet, systolic blood pressure was lower, and cardiovascular disease risk indices improved more in participants receiving fruits and vegetables than in those receiving NaHCO3 or Usual Care. These cardiovascular benefits of fruits and vegetables were achieved despite lower doses of pharmacologic chronic kidney disease and cardiovascular disease protection.
CONCLUSIONS: The trial supports fruits and vegetables as foundational hypertension treatment to reduce chronic kidney disease progression and cardiovascular disease risk.
METHODS: We randomized 153 hypertensive macroalbuminuric patients receiving pharmacologic chronic kidney disease and cardiovascular disease protection to get fruits and vegetables, oral NaHCO3, or Usual Care. We assessed the course of kidney disease progression and cardiovascular disease risk indices over five years.
RESULTS: Chronic kidney disease progression was slower in participants receiving fruits and vegetables or oral NaHCO3 than Usual Care [mean (SE)] [-1.08 (0.06) and -1.17 (0.07) vs. -1.94 (0.11) mL/min/1.73m2/ year, respectively, P\'s< .001). Yet, systolic blood pressure was lower, and cardiovascular disease risk indices improved more in participants receiving fruits and vegetables than in those receiving NaHCO3 or Usual Care. These cardiovascular benefits of fruits and vegetables were achieved despite lower doses of pharmacologic chronic kidney disease and cardiovascular disease protection.
CONCLUSIONS: The trial supports fruits and vegetables as foundational hypertension treatment to reduce chronic kidney disease progression and cardiovascular disease risk.
摘要：
背景：高水果和蔬菜饮食与减少慢性肾脏疾病和心血管疾病有关，但很少用于高血压治疗。低酸饮食也与减少慢性肾脏疾病和心血管疾病有关。和水果和蔬菜或口服碳酸氢钠（NaHCO3）降低膳食酸。
方法：我们将153名接受慢性肾脏病和心血管疾病药物保护的高血压大白蛋白尿患者随机分配，以获得水果和蔬菜，口服NaHCO3或常规护理。我们评估了五年来肾脏疾病进展和心血管疾病风险指数的过程。
结果：接受水果和蔬菜或口服NaHCO3的参与者的慢性肾脏疾病进展比常规治疗慢[平均值（SE）][-1.08（0.06）和-1.17（0.07）vs.-1.94(0.11)mL/min/1.73m2/年,分别,P\'s<.001)。然而，收缩压较低,与接受NaHCO3或常规护理的参与者相比，接受水果和蔬菜的参与者的心血管疾病风险指数改善更多。尽管有较低剂量的慢性肾脏疾病和心血管疾病保护作用，水果和蔬菜的这些心血管益处还是实现了。
结论：该试验支持水果和蔬菜作为基础高血压治疗，以降低慢性肾病进展和心血管疾病风险。
方法：我们将153名接受慢性肾脏病和心血管疾病药物保护的高血压大白蛋白尿患者随机分配，以获得水果和蔬菜，口服NaHCO3或常规护理。我们评估了五年来肾脏疾病进展和心血管疾病风险指数的过程。
结果：接受水果和蔬菜或口服NaHCO3的参与者的慢性肾脏疾病进展比常规治疗慢[平均值（SE）][-1.08（0.06）和-1.17（0.07）vs.-1.94(0.11)mL/min/1.73m2/年,分别,P\'s<.001)。然而，收缩压较低,与接受NaHCO3或常规护理的参与者相比，接受水果和蔬菜的参与者的心血管疾病风险指数改善更多。尽管有较低剂量的慢性肾脏疾病和心血管疾病保护作用，水果和蔬菜的这些心血管益处还是实现了。
结论：该试验支持水果和蔬菜作为基础高血压治疗，以降低慢性肾病进展和心血管疾病风险。
