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Now I want to show you a randomized controlled trial with respect to blood pressure
下面講一個關于血壓的隨機試驗
This was published in Germany. Now nine years ago
9年前發(fā)表于德國
I'm just amazed that nobody seems to know about it
我很驚訝，竟然沒人知道它
A perfectly good journal, Clinical Endocrinology & Metabolism
臨床內分泌代謝雜志，它其實很棒
148 older women double-blind randomized trial
148名老年婦女，雙盲隨機試驗
The baseline 25D was below 50 nmol
基線25D低于50納摩
It's kind of typical of what we would find in the US and they were treated for eight weeks either with calcium alone or with calcium plus vitamin D
這和美國的典型值一樣，治療8周，部分只用鈣，部分是鈣+維生素D
Modest dose eight hundred international units So，that was a pretty good dose for people back then
適度劑量 800國際單位，這在當時算不錯的劑量了
Back then, only eight years ago, nine years ago
當時，其實也就八九年前
Now it's known that calcium lowers blood pressure
鈣能降低血壓
We don't use it for the treatment hypertension because it doesn't lower it enough
這不用于高血壓治療，因為降低程度不夠
but at a population level that's been clearly established
不過就公共健康而言這顯然有用
that you lower blood pressure with calcium usefully as a matter of fact
補鈣確實能降低血壓
but not therapeutically useful. So there's a difference there
只是不用于治療而已，這有差別
So the question was not so much that calcium do it
因此問題不是鈣降血壓這一事實
but there's vitamin D add something to the calcium which would be better than the calcium alone
而是維生素D+鈣是否比只用鈣要好
and what we have is simply an 8-week trial
這只是簡單的8周試驗
This is one of those acute effects that you can produce very early on
這個效果很快就能顯現出來
The gray bars are the baseline values
灰色條形圖是基線值
for the calcium only group, for the calcium + D group
左側是只補鈣，右邊是鈣+維生素D
And the open bars are the 8-week values at the end of the briefly treatment period
空心條形圖是8周治療后的值
5.7 millimeter of mercury drop from calcium alone
只補鈣，降低5.7毫米汞柱，
which I think you would agree with me is useful from a public health standpoint but may not be enough if you're treating a patient with clear hypertension
大家肯定贊同，這對公共健康有用，但對高血壓患者治療卻不夠
So I guess I make that distinction
這有必要區(qū)別開
