臺灣博碩士論文加值系統

背景 行政院衛生署公佈 2005 至 2008國民營養健康狀況變遷調查結果顯示65歲以上男女高血壓盛行率分別為55.9%與52.3%。2008至2012年，高血壓每十萬人口死亡率，有逐年上升之勢，顯示我國在高血壓防治工作上，仍須積極努力。
目的 針對內湖科學園區附近的高血壓前期和第一期的上班族進行得舒飲食教育介入，並評估教育介入對其營養知識、飲食行為、自我效能和血壓的影響。
研究方法與設計 本研究於2013年，招募內湖科學園區及其周邊港都里與港華里的60位高血壓前期和第一期的上班族，運用健康信念模式 （Health Belief Model, HBM） 強調 「自我效能」（self-efficacy），進行一對一個別得舒飲食教育，希望藉由得舒飲食 （Dietary Approaches to Stop Hypertension, DASH） 以及生活方式的修正，幫助受試者達到維持正常血壓的效果。60位受試者在8週介入期間，每隔週接受血壓、體位測量、飲食諮商以及填寫24小時飲食回憶；並在前測（第零週）、後測（第8週）、追蹤（第16週）填寫營養知識、飲食行為、自我效能問卷。
結果 前測時60位受試者平均收縮壓為133.8±15.0 mmHg，舒張壓為86.4±6.5mmHg，實施得舒飲食8週後，平均收縮壓降為122.5±14.9 mmHg（與前測相較P<0.001）舒張壓為77.7±9.8 mmHg（與前測相較P<0.001）；第16週追蹤時，平均收縮壓降為）119.6±13.2 mmHg （與追蹤相較P<0.024），舒張壓為75.3±8.4 mmHg（與追蹤相較P<0.006）。
結論 運用健康信念模式強調「自我效能」的得舒飲食教育介入對於內湖科學園區附近高血壓前期，以及第一期的上班族，可以有效的增加營養知識、改善飲食行為、加強自我效能、調降血壓且可維持至第16週。

Background According to the Ministry of Health and Welfare, during 2005 and 2008, the prevalence rates of hypertension for men and women aged 65 years or older were 55.9% and 52.3% respectively. However, the mortality rate of hypertension per hundred thousand population during 2008 and 2012 had risen up gradually. In view of the continuing epidemic of BP-related diseases and the increasing prevalence of hypertension, efforts to reduce BP in both nonhypertensvie and hypertensive individuals are warranted.
Purpose The aim of the research was to give prehypertensive or hypertensive individuals working in or around Neihu Technology Park the tailored one on one intervention of Dietary Approaches to Stop Hypertension（DASH）and then assessed if the intervention did help them improve their nutrition knowledge, dietary practice, self-efficacy, and eventually lowered their blood pressures.
Methods In 2013, 60 participants working in Neihu Technology Park and its surrounding Gangdu Borough and Ganghua Borough were recruited for the research. In 8 weeks, Health Belief Model with an emphasis on self-efficacy was incorporated to the DASH intervention on one on one basis. The participants’ blood pressures, waist circumferences, body fat, height, and weight were measured, and their 24-hour dietary recalls were collected every other week. Each participant also filled out questionnaires regarding nutrition knowledge, dietary practice, and self-efficacy in pretest（week 0）, posttest（week 8）, and follow- up（week 16）.
Results At baseline（week 0） , the mean systolic blood pressure was 133.8±15.0 mmHg, and the mean diastolic blood pressure was 86.4±6.5mmHg. After 8 weeks of intervention, the mean systolic blood pressure and diastolic blood pressure dropped to122.5± 14.9mmHg, and 77.7±9.8 mmHg（compared to baseline systolic, and diastolic blood pressures, both P<0.001）. In week 16, the mean systolic blood pressure and diastolic blood pressure further dropped to 119.6±13.2mmHg（compared to week 8, P<0.024）, and 75.3±8.4mmHg（compared to week 8 , P<0.006）.
Conclusion Incorporating Health Belief Model with an emphasis on self-efficacy in DASH intervention tailored to prehypertensive and hypertensive working individuals in the research proved to be feasible signigicantly.

中文摘要 Ⅰ
英文摘要 Ⅲ
致謝 Ⅴ
目錄 Ⅶ
圖目次 Ⅹ
表目次 VII
第一章 緒論 1
第二章 文獻回顧
第一節 名詞界定 3
第二節 高血壓的盛行率 4
第三節 高血壓的危險因素 7
第四節 與高血壓有關的疾病 14
第五節 高血壓防治的重要性暨方法 16
第六節 得舒飲食計畫（DASH Eating Plan） 18
第七節 健康信念模式與自我效能 24
第三章 材料與方法
第一節 研究目的 28
第二節 研究問題 28
第三節 研究設計與流程 29
第四節 研究對象 32
第五節 營養教育介入模式 33
第六節 研究工具 36
第七節 測量儀器與方法 38
第八節 資料整理與統計分析 39
第四章 研究結果
第一節 前測的基本資料 41
第二節 前測、後測、追蹤的營養知識、飲食行為、自
我效能得分以及血壓和基本體位測量之比較 42
第三節 營養知識、飲食行為、自我效能得分分析 44
第五章 討論
第一節 營養教育介入成效 76
第二節 研究結果 77
第六章 結論
第一節 結論 81
第二節 未來方向 81
第七章 參考文獻
第一節 英文文獻 82
第二節 中文文獻 90
第八章 附錄
附錄一 人體試驗核准通知函 91
附錄二 執行效期展延通過證明 92
附錄三 修正案通過證明 93
附錄四 執行效期展延通過證明 94
附錄五 得舒降血壓手冊 95
附錄六 得舒飲養知識、飲食行為、自我效能正式施測問卷 115
附錄七　飲食記錄方法說明與範例 122
附錄八　填寫範例 123
附錄九　填寫表格 124
附錄十 得舒飲食每日建議攝取量 125
附錄十一 各類食物份量換算 126
附錄十二 蔬果汁 127
附錄十三 得舒一餐 128
附錄十四 他們的故事 129


圖目次
圖1. 效能、行為與結果的關係 26
圖2. HBM與Self-efficacy的建構圖 27
圖3. 研究設計 30
圖4. 研究流程 31
圖5. 運用HBM強調Self-efficacy運用於教育介入 34
圖6. 血壓改變結果 75


表目次
表 1. 18歲以上成人高血壓分類標準及定義 4
表 2. 2001全球因高血壓死亡和失能調整生命年比例 5
表 3. 高血壓防治的生活方式 17
表 4. DASH每日營養目標 （2100卡的飲食計畫） 18
表 5. 符合DASH營養成份的每日攝取份數 19
表 6. HBM與SCT的比較 25
表 7. 得舒營養教育課程大綱 34
表 8. 得舒飲食問卷各分類及內容 36
表 9. 24小時飲食回憶 37
表 10. 統計方法分析 40
表 11. 受試者之基本資料表 47
表12. 前測（0週）、後測（第8週）、追蹤（第16週）營養知識
各題平均得分 49
表13. 前測（0週）、後測（第8週）、追蹤（第16週）營養知識
各題平均得分其改變量之比較 50
表14. 前測（0週）、後測（第8週）、追蹤（第16週）飲食行為
各題平均得分 52

表15. 前測（0週）、後測（第8週）、追蹤（第16週）飲食行
為各題平均得分其改變量之比較 54
表16. 前測（0週）、後測（第8週）、追蹤（第16週）自我效
能各題平均得分 56
表17. 前測（0週）、後測（第8週）、追蹤（第16週）自我效
能各題平均得分其改變量之比較 58
表 18. 前測（0週）、後測（第8週）、追蹤（第16週）基本體
位（體重 BMI體脂 腰圍 SBP/DBP）和營養知識、行
為、自我效能比較 60
表 19. 前測、後測、追蹤營養知識、飲食行為、與自我效能改變
對血壓的影響 61
表20. 營養知識、飲食行為、自我效能的性別差異 62
表21. 營養知識、飲食行為、自我效能在教育程度的差異 63
表22. 營養知識、飲食行為、自我效能在前測、後測、以及
追蹤時的相關性 64
表 23. 飲食行為前測（第0週）、後測（第8週）及追蹤
（第16週）的得分率 65
表24. 飲食行為前測（第0週）、後測（第8週）、追蹤（第16週）
飲食行為得分率之比較 67
表 25. 自我效能前測（第0週）、後測（第8週）及追蹤
（第16週）的得分率 68
表26. 前測（第0週）、後測（第8週）、追蹤（第16週）
自我效能得分率之比較 70
表27. 高血壓盛行率在第2週、第4週、第8週、第16週
的改變 72
表28. 24小時飲食記錄DASH目標飲食前測、後測、追蹤時
的份量 73
表29. 24小時飲食記錄DASH目標飲食前測、後測、追蹤時
的份量改變 74

第一節 英文文獻
A global brief on HYPERTENSION. World Health Organization, 2013.

Abramson JL, Lewis C, Murrah NV.（2010）Relationship of self-reported alcohol consumption to ambulatory blood pressure in a sample of healthy adults. Am J Hypertens. 23（9）:994-9

Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP,Paul Elliott ,
Francesco P.（2013）Effect of increased potassium intake on cardiovascular risk factors
and disease: systematic review and meta-analyses. BMJ. 346:f1378

Ammerman AS, Lindquist CH, Lor KN, Hersey J.（2002）The Efficacy of Behavioral
Interventions to Modify Dietary Fat and Fruit and Vegetables Intake: A Review of the Evidence. Preventive Medicine. 35:25-41

Appel LJ, Frohlich ED, Hall JE, Pearson TA, Sacco RL, Seals DR, Sacks FM, Smith SC, Jr, Dorothea K. Vafiadis Jr. DK, Horn LVV.（2011）The Importance of Population-Wide Sodium Reduction as a Means to Prevent Cardiovascular Disease and Stroke : A Call to Action From the American Heart Association. Circulation. 123:1138-1143

Appel LJ, Moore TJ, Obrzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N.（1997）A clinical trial of the effects of dieary patterns on blood pressure. N Engl J Med. 336:1117-24

Ard JD, Coffman CJ, Lin PH, Svetkey LP.（2004）One-year follow-up study of blood
pressure and dietary patterns in dietary approaches to stop hypertension（DASH）-sodium participants. Am J Hypertens. 17（12 Pt 1）:1156-62

Ascherio A, Hennekens C, Willett WC, Sacks F, Rosner B, Manson J, Witteman J, Stampfer MJ.（1996）Prospective study of nutritional factors, blood pressure, and hypertension among US women. Hypertension. 27（5）:1065-72

Bandura A.（1997）Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura A.（1995）Self-Efficacy In Changing Societies. Cambridge University Press.

Baqhianimoqhadam MH, Shoqafard G, Sanati HR, Baqhianimoqhadam B,Mazloomy SS,
Askarshahi M. （2013）Application of the Health Belief Model in promotion of self-care in heartfailure patients. Acta Med Iran. 51（1）:52-8

Berenson GS, Srinivasan SR, Bao W.（1997）Precursors of cardiovascular risk in young adults from a biracial （black-white） population: The Bogalusa Heart Study. Ann N Y Acad Sci. 817:189-98

Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L,Lin PH, Caccia D, Johnson J,Waugh R, Sherwood A.（2010）Effects of the DASH Diet alone and in combination withexercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Arch Intern Med. 170（2）:126-135

Brown IJ, Stamler J, Horn LV, Robertson CE, Chan Q, Dyer AR,Huang CC, Rodriguez , Zhao L, Daviglus ML, Ueshima H, Elliott P.（2011）Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure : International study of macro/micronutrients and blood pressure. Hypertension. 57:695-701

Cena H, Tesone A, Niniano R, Cerveri I, Roggi C, Turconi G.（2013）Prevalence rate of metabolicsyndrome in a group of light and heavy smokers. Diabetology & Metabolic Syndrome. 5:28

Chaix B, Bean k, Leal C, Thomas F, Havard S, Evans D, Jego B, Pannier B.（2010） Individual/Neighborhood social factors and blood pressure in the RECORD cohort study : Which risk factors explain the associations?Hypertension. 55:769-775

Chen L, Caballero B, Mitchell DC, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Batch BC, Anderson CAM, Appel LJ.（2010）Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure : A prospective study among United States adults. Circulation. 121:2394-2406

Conen D, Glynn RJ, Ridker P, Buring JE, Albert MA.（2009）Socioeconomic status, blood pressure progression, and incident hypertension in a prospective cohort of female health professionals. European Heart Jounal. 30:1378 - 1384

Cornoni-Huntley J, LaCroi AZ, Havlik RJ. （1989）Race and sex differentials in the impact of hypertension in the United States. Arch Intern Med. 149:780-788

Davis JL, Buchanan KL, Green BL.（2013）Racial/ethnic differences in cancer prevention beliefs: applying the health belief model framework. Am J Health Promot. 27（6）:384-9

Dietary Guidelines for Americans; 2010（cited 2011 July 30﹞. Available from: http://www.cnpp.usda.gov/DGAs2010-policyDocuent.htm.

Dochi M, Sakata K, Oishi M, Tanaka K, Kobayashi E, Suwazono Y.（2009）Smoking as an independent risk factor for hypertension: a 14year longitudinal study in male Japanese workers. Tohoku J Exp Med. 217（1）:37-43

Dyer AR, Liu K, Walsh M, Kiefe C, Jaobs DR Jr, Bild DE.（1999）Ten-year incidence of elevated blood pressure and its predictors: CARDIA study. Coronary Artery Risk Development In （Young） Adults. J Hum Hypertens. 13（1）:13-21

Ellis J, Johnson MA, Fischer JG, Hargrove JL.（2005）Nutrition and health education intervention for whole grain foods in the Georgia Older Americans Nutrition Program. J Nutr Elder. 24（3）:67-83

Engberink MF, Geleijnse JM, Jong N, Smit HA, Kok HJ,Verschuren WMM.（2009） Dairy Intake, Blood Pressure and Incident Hypertension in a General Dutch Population. J. Nutr. 139: 582–587

Franklin SS, Larson MG, Khan SA, Wong ND, Leip EP, Kannel WB,, Levy D.（2001） Does the Relation of Blood Pressure to Coronary Heart Disease Risk Change With Aging? Circulation 103:1245-9

Fodor G, Cutler H, Irvine J, Ramsden V, Tremblay G, Chockalinham A.（1998）Adherence to Non-pharmacologic Therapy for Hypertension: Problems and Solutions. Canadian Journal of Public Health. 89（5）, 112-5

He J, Whelton PK. （1999）Elevated systolic blood pressure as a risk factor for cardiovascular and renal disease. J Hypertens Suppl. 17（2）:S7-13
He J, Whelton PK, Appel LJ, Charlseton J, Klag MJ.（2000）Long-Term Effects of Weight Loss and Dietary Sodium Restriction on Incidence of Hypertension. Hypertension. 35:544-549
Houston MC.（2011）The importance of potassium in managing hypertension.
Curr Hypertens Rep. 13（4）:309-17
Hyman DJ, Pavlik VN. （2001） Characteristics of patients with uncontrolled hypertension in the United States. N Wnfl J Med. 345:479-86

Janz NK, Becker MH.（1984）The health belief model: A decade later. Health Education Quarterly. 11:1-47

Kearney PM, Whelton M, Reynolds K, Muntner P, Reynolds K, Whelton PK, He J.（2004）Worldwide prevalence of hypertension: a systematic review. Journal of Hypertension. 22（1）:11-19

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J.（2005）Global burden of hypertension: analysis of worldwide data. Lancet. 365:217-23

Lawes C MM, Hoorn SV, Rodgers A.（2008）Global burden of blood-pressure related disease, 2001. Lancet. 371:1513-18

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R.（2002）Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual dat for one million adults in 61 prospective studes. Prospective Studies Collabortion. Lancet. 360:1903-13

Linde JA, Rothman AJ, Baldwin AS, Jeffery RW.（2006）The impact of self efficacy on behavior change and weight change among overweight participants in a weight loss trial. Health Psychology. 25（3）, 282-291

Lin PH, Appel LJ, Funk K, Craddick S, chen C, Elmer P, Mcburnie MA, Champagne C. （2007）The PREMIER intervention helps participants follow the Dietary Approaches to Stop Hypertension Dietary pattern and the current Dietary Reference Intakes Recommendations. American Dietetic Association. volume 107, No. 9


Liu L, Mizushima S, Ikeda K, Hattori H, Miura A, Gao M, Nara Y, Yamori Y.（2000） Comparative studies of diet-related factors and blood pressure among Chinese and Japanese: results from the China-Japan cooperative research of the WHO-CARDIAC study. Hypertens Res. 23: 413-420

Lloyd-Jones DM, Evans JC, Larson MG, O’Donnell CJ, Roccella EJ, Levy D.（2000） Differential control of systolic and diastolic blood pressure: Factors associated with lack of blood pressure control in the community. Hypertension . 36:594-9

Lloyd-Jones DM, Dyer AR, Wang R, Daviglus ML, Greeland P.（2007） Risk factor burden in middle age and lifetime risks for cardiovascular and non-vascular death （Chicago Heart Association Detection Project in Industry）. Am J Cardiol. 15; 99（4）: 535-540

Macken LC, Yates B, Blancher S.（2000）Concordance of risk factors in female spouses of male patients with coronary heart disease. J Cardopulm Rehabil. 20（6）: 361-8

Marmot MG, Elliott P, Shipley MJ, Dyer AR, Ueshima H, Beevers DG, Stamler R, Kesteloot H, Rose G, Stamler J.（1994）Alcohol and blood pressure : the INTERSALT study. BMJ. 308: 1263-7

Moore TJ, Alsabeeh N, Apovian CM, Murphy MC, Coffman GA, Cullum-Dugan D, Jenkins M, Cabral H.（2008）Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program（DASH for health）: longitudinal observational study. J Med Internet Res. 10（4）: e52

Morisky DE, DeMuth NM, Field-Fass M, Green LW, Levine DM.（1985）Evalution of Family Health Education to Build Social Support for Long-Term Control of High Blood Pressure. Health Educ Behav. 12（1）:35-50

National High Blood Pressure Education Program.（1991）National high blood pressure education program working group report on hypertension and chronic renal failure. Arch Intern Med. 151:1280-1287

Neaton JD, Blackburn H, Jacobs D, Kuller L, Lee DJ, Sherwin R, Shih J, Stalmer J, Wentworth D. （1992） Serum cholesterol level and mortality findings for men screened in the multiple risk factor intervention trial. Arch Intern Med. 152:1490-1500

Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Lin PH, Karanja NM, Miller III ER, Windhauser MM, Moore TJ, Swain JF, Bales CW, Prochan MA.（2001）Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension （DASH） trial. Am J Clin Nutr . 74:80-9

Obarzanek E, Vollmer WM, Lin PH, Cooper LS. Young DG, Svetkey LP, Harsha Dw, Elmer PJ, Appel LJ.（2007）Effects of individual components of multiple behavior changes: The PREMIER Trial. Am J Health Behav. 31（5）:545-560

Pomerleau J, Lock K, Knai C, McKee M. （2005） Interventions designed to increase adult fruit and vegetable intake can be effective: A Systematic Review of the Literature. J. Nutr. 135: 2486-2495

Rankins J, Sampson W, Brown B, Jenkins-Salley T.（2005）Dietary Approaches to Stop Hypertension（DASH） intervention reduces blood pressure among hypertensive African American patients in a neighborhood health care center. J Nutr Educ Behav. 37（5）:259-64

Rangan AM, Flood VL, Denyer G, Ayer JG, Webb KL, Marks GB, Celermajer DS, Gill TP.（2012）The effect of dairy consumption on blood pressure in mid-childhood: CAPS cohort study. Eur J Clin Nutr. 66（6）:652-7

Ruidavets JB, Bongard V, Simon C, Dallongeville J, Ducimetiere P, Arveiler D, Amouyel P, Bingha A, Ferrieres J.（2006）Independent contribution of dairy products and calcium intake to blood pressue variations at a population leve. J Hypertens. 24（4）:671-81

Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldsten LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC,Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T.（2006）Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack : A statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council of Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke. 37:577-61

Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, Karanja N, Lin PH, Steele P, McCullough M, Appel LJ, Bray GA, Vogt TM, Moore TJ.（1995）Rationale and design of the Dietary Approaches to Stop Hypertension Trial（DASH）: A multicenter controlled-feeding study of dietary pattern to lower blood pressure. Ann Epidemiol . 5:108-11

Sacks N, Cabral H, Kazis L, Marrett KM, Vetter D, Richmond R, Moore TJ.（2009）A Web-Based Nutrition Program Reduces Health Care Costs in Employees With Cardiac Risk Factors: Before and After Cost Analysis. J Med Internet Res. 11（4）: e43

Slater MD. （1989） Social Influences and Cognitive Control as Predictors of Self-Efficacy and Eating Behavior. Cognitive Therapy and Research. Vol. 13, No. 3

Song Y, Sesso HD, Manson JE, Cook NR, Buring JE, Liu S.（2006）Dietary magnesium intake and risk of incident hypertension among middle-aged and older US women in a 10-year follow-up study. Am J Cardiol. 98（12）: 1616-21

Stamler J, Stamler R, Neaton JD.（1993）Blood pressure, systolic and diastolic, and cardiovascular risks. Arch Intern Med. 153:598-615

Stevens J, Truesdale KP, Katz EG, Cai Jianwen.（2006）Impact of body mass index on incident hypertension and diabetes in Chinese Asians, American Whites, and American Blacks. Am J Epidemiol. 167（11）:1365-74

Svetkey LP, Harsha Dw, Vollmer WM, Stevens VJ, Obarzanek E, Elmer PJ, Lin PH, Champagne C, Morton DGS, Aickin M, Proschan MA, Appel LJ.（2003）PREMIER: A clinical trial of comprehensive lifestyle modification for blood pressure control : rationale, design and baseline characteristics. Ann Epidemiol. 13; 462-471

Svetkey LP, Morton DS, Vollmer WM, Appel LJ, Xonlin PR, Ryan DH, Ard J, Kennedy BM.（1999）Effects of Dietary Patterns on Blood Pressure Subgroup Analysis of the Dietary Approaches to Stop Hypertension（DASH）Randomized Clinical Trial. Arch Intern Med. 159（3）: 285-293

Svetkey LP, Harsha Dw, Vollmer WM, Stevens VJ, Obarzanek E, Elmer PJ, Lin PH, Champagne C, Morton DGS, Aickin M, Proschan MA, Appel LJ.（2003）Effects of Comprehensive Lifestyle Modification on Blood Pressure Control: Main Results of the PREMIER Clinical Trial. JAMA 289:2083 - 2093

U.S. Department of Health and Human Services, National Institues of Health, Natioal Heart, Lung, and Blood Institues.（1998）DASH Eating Plan lower your blood pressure. NIH Publication No. 06-4082, revised April 2006

U.S. Department of Health and Human Services, National Institues of Health, Natioal Heart, Lung, and Blood Institue, National High Blood Pressure Education Program （2004）. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, nd Treatment of High Blood Pressure. NIH Publication No 04-5230.


U.S. Department of Health and Human Services. National Heart, Lung, and Blood Institue.（2012）What Is High Blood Pressure?

Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D’Agostino RB, Levy D. （2002）Residual lifetime risk for d eveloping hypertension in middle-aged women and men. The Framingham Heart Study. 287:1003-1010

Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D.（2001）Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study : a cohort study. Lancet. 358: 1682-86

Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ,Kannel WB, Levy D.（2001） Impact of high-normal blood pressureon the risk of cardiovascular disease. N Engl J Med. 345:1291-7

Wang L, Manson JE, Buring JE, Lee I, Sesso HD.（2008）Dietary Intake of Dairy Products, Calcium, and Vitamin D and the Risk of Hypertension in Middle-Aged and Older Women. Hypertension. 51:1073-1079

Whelton PK, Appel LJ, Espeland MA, Applegate Wb, Ettinger WH, Kostis JB, Kumanyika S, Lacy CR, Johnson KC, Folmar S, Cutler JA.（1998）Sodium reduction and weight loss in the treatment of hypertension in older persons. JAMA. 279:839-846

World Health Report 2002: reducing risks, promoting healthy life. Geneva, Switzerland: World Health Organization. http://www.who.int/whr/2002/.
Young DR, Coughlin J, Jerome GJ, Myers V, Chae SE, Brantley PJ.（2010）Effects of the PREMIER Interventions on Health-Related Quality of Life. Ann Behav Med. 40（3）: 302–312.
第二節 中文文獻

白其卉（2008）2007年台灣地區高血壓、高血糖、高血脂之追蹤調查研究。行政院衛生署國民健康署 。http://www.bhp.doh.gov.tw/bhpnet/portal/file/ThemeDocFile/201102140310199776/2007%E4%B8%89%E9%AB%98%E5%B0%88%E8%BC%AF_20110211.pdf
檢索日期 : 2013年1月10日

行政院衛生署國家衛生研究院（2010）2005至 2008國人高血壓之狀況國民營養健康狀況變遷調查。
http://nahsit.survey.sinica.edu.tw/node/34
檢索日期 :2013年1月2日
行政院衛生署（2012）我國近十年高血壓死亡人數
衛生統計資訊網 http://www.doh.gov.tw/statistic/index.htm
檢索日期 : 2014年6月10日。

吳秀英（2006）台灣地區國人對慢性疾病預防認知及預防保健服務利用情形初探－2005 年國民健康訪問暨藥物濫用調查結果。

吳幸娟、、潘文涵、葉乃華、張新儀、洪淑怡（2013）台灣成人與老人營養素及食物攝取來源之變遷趨勢 : 由 NASHIT 1993～1996到2005～2008

得舒飲食每日建議攝取量。董氏基金會食品營養組：http://nutri.jtf.org.tw/
檢索日期 : 2013年7月5日

蔡正亮（2011）得舒（DASH）營養教育對高血壓者的營養知識、行為、自我效能和血壓的影響。北醫保健營養學系碩士論文