Abstract: Objective　To investigate the mechanism of action of modified dietary pattern on reducing the levels of inflammatory markers and hypertension management in overweight or obese middle-aged and older people with hypertension from Zhangfang Village of Beijing's Fangshan District based on our previous studies.Methods　This trial was implemented from May 21st to July 1st，2017.From the database of middle-aged and older villagers（245 cases aged 45-75）of Zhangfang Village of Beijing's Fangshan District，54 overweight or obese cases with grade 1 hypertension were sampled based on the inclusion and exclusion criteria and were randomized into group A（n=27）eating a standardized balanced diet and group B（n=27）eating a standardized balanced diet supplemented by anti-atherosclerotic powdered foods.Then，according to the completion status of trial，30（15 in group A and 15 in group B）were included in the final analysis.We collected the data about the levels of inflammatory markers〔high-sensitivity C-reactive protein（hs-CRP），soluble intercellular adhesion molecule-1（sicam-1），vascular cell adhesion molecule-1（VCAM1），nuclear factor-kappa B（NF-κB），integrin，E-selectin，interleukin-6（IL-6），interleukin 10（IL-10），toll-like receptor 2（TLR2），toll-like receptor 4（TLR4）〕measured before the intervention（T0），during the intervention（T1）and at the end of the intervention（T2）and dietary inflammatory index（DII）at T0 and T2.Results　The DII in group B was lower than that of group A（P<0.05）.The DII in group B decreased significantly at T2 compared with at T0（P<0.05）.The intervention program and duration exerted interactive effects on IL-10（P<0.05）.Intervention program produced significant main effects on NF-κB，integrin and E-selectin（P<0.05）.And intervention duration had main effects on sicam-1，VCAM1，NF-κB，integrin，E-selectin，IL-6 ，and TLR2（P<0.05）.At T0，the levels of NF-κB，integrin and E-selectin were lower in group B compared with group A，when at T2，the levels of NF-κB and integrin were still lower in group B（P<0.05）.For group A，compared with at T0，at T1，only the level of integrin decreased significantly，but at T2，besides integrin，the levels of NF-κB，E-selectin，IL-6 decreased significantly（P<0.05）.Moreover，TLR2 at T2 declined significantly compared with at T1（P<0.05）.For group B，compared with at T0，sicam-1，VCAM1 and integrin decreased significantly at T1（P<0.05），and at T2，besides the above 3 markers，IL-6 also decreased significantly（P<0.05）.Furthermore，sicam-1，NF-κB，E-selectin，and TLR2 were much lower compared with at T1（P<0.05）.Conclusion　After eating a balanced diet and a modified balanced diet（by adding anti-atherosclerotic powdered foods），the middle-aged and elderly overweight or obese patients with hypertension presented reduced levels of inflammatory markers，increased anti-inflammatory capabilities as well as good hypertension management outcome.

Key words: Hypertension, Diet, Inflammation, Dietary inflammatory index, Inflammatory index

摘要： 目的　在前期研究基础上，观察再次改善膳食模式对北京市房山区张坊村中老年超重或肥胖高血压患者炎性指标的影响，探讨这种膳食模式对血压产生影响的可能机制。方法　2017-05-21至2017-07-01，根据纳入与排除标准，从北京市房山区张坊村245例中老年（45~75岁）村民数据库中，选取超重或肥胖的1级高血压患者54例为研究对象。采用随机数字表法将其分为A组（27例，采用标准均衡膳食）和B组（27例，采用补充抗动脉粥样硬化食疗粉的均衡膳食）。按照剔除标准，最终共纳入30例患者，其中A组15例，B组15例。记录干预前、干预后的总膳食炎症指数（DII）及干预前（T0）、干预中（T1）、干预结束（T2）时患者炎性指标〔超敏C反应蛋白、血清可溶性细胞间黏附分子-1、可溶性血管细胞黏附分子-1、核因子κB、整合素、E-选择素、白介素6、白介素10、Toll样受体2（Toll-2）、Toll样受体4（Toll-4）〕。结果　B组干预后总DII低于A组（P<0.05）；B组干预后总DII低于干预前（P<0.05）。干预方法与时间在白介素10上有交互作用（P<0.05）；干预方法在核因子κB、整合素、E-选择素上主效应显著（P<0.05）；时间在可溶性细胞间黏附分子-1、可溶性血管细胞黏附分子-1、核因子κB、整合素、E-选择素、白介素6、Toll-2上主效应显著（P<0.05）。B组T0、T2时核因子κB、整合素低于A组，T0时E-选择素低于A组（P<0.05）；A组T1时整合素低于T0时，T2时核因子κB、整合素、E-选择素、白介素6低于T0时，T2时Toll-2低于T1时（P<0.05）；B组T1时可溶性细胞间黏附分子-1、可溶性血管细胞黏附分子-1、整合素低于T0时，T2时可溶性细胞间黏附分子-1、核因子κB、整合素、白介素6低于T0时，T2时可溶性细胞间黏附分子-1、核因子κB、E-选择素、Toll-2低于T1时（P<0.05）。结论　对北京市房山区张坊村中老年超重或肥胖高血压患者给予标准均衡膳食和补充抗动脉粥样硬化食疗粉的均衡膳食后，其抗炎能力提高，可以有效降低机体炎性指标，且具有显著的降压效果。

关键词: 高血压, 膳食, 炎症, 膳食炎性指数, 炎性指标