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Multiple Trials Demonstrate Efficacy of Dietary Approaches to Stop Hypertension Diet in Lowering Blood Pressure

The Dietary Approaches to Stop Hypertension (DASH) diet should be promoted along with other lifestyle changes to help patients lower blood pressure and reduce the risk of cardiovascular disease (CVD), according to the authors of a review article on the subject.

In their report, Shirley Craddick, MD, with the Kaiser Permanente Center for Health Research, Portland, Oregon, United States, and colleagues describe the findings of the original DASH study, which began in 1993, as well as more recent studies involving the DASH diet.

The diet is high in fruits, vegetables, and low-fat dairy products, and minimises fats, red meat, sweets, and sugar-containing beverages. In addition, compared with the control diet in the original study, the DASH diet had lower levels of total fat, saturated fat, and cholesterol, and higher levels of potassium, calcium, magnesium, fibre, and protein.

According to Dr. Craddick and colleagues, several innovative features of the DASH trials are important to note. First, the trials were the first in the area of nutrition and blood pressure research to shift the focus from individual nutrients to dietary patterns. In addition, they used large samples sizes, which ensured that small changes in blood pressure could be detected.

The original study found that the effects of the DASH diet were especially pronounced in individuals with stage 1 hypertension, in whom blood pressure was reduced on average by 11.4/5.5 mmHg.

Other studies involving the DASH diet include the DASH-sodium trial, the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT), and a randomised controlled trial that tested the hypothesis that the DASH diet enhanced response to losartan in patients with stages 1 and 2 hypertension.

The DASH-sodium trial evaluated the influence of sodium intake on the efficacy of the DASH diet. It found that the effects of the diet and sodium reduction on blood pressure were not fully additive, but the lowest blood pressures were consistently observed when individuals ate the DASH diet at the lowest sodium level.

Another trial, DEW-IT, was a 9-week study that incorporated weight loss, sodium reduction, increased physical activity, and a hypocaloric version of the DASH diet. The intervention resulted in blood pressure reductions similar to those from pharmacotherapy (9.5/5.3 mmHg) compared with the control group.

Yet another trial evaluating losartan found that losartan combined with the DASH diet significantly reduced blood pressure compared with losartan and a control diet.

According to the researchers, encouragement from public health organizations, healthcare systems, and societal institutions can help individuals adopt a healthy lifestyle.

"These lifestyle changes can substantially lower the risk of CVD as well as the risk of other chronic diseases, including diabetes, osteoporosis, and perhaps cancer. The DASH dietary pattern is one big step along the path to managing blood pressure and maintaining good health," they conclude.


Curr Atheroscler Rep 2003;5:484-491. "The DASH Diet and Blood Pressure"

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