Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control

Abstract

The authors hypothesized that the Dietary Approaches to Stop Hypertension (DASH) diet and reduced sodium intake would control stage 1 hypertension and reduce high-normal blood pressure (BP) to optimal levels. Adults with systolic BP 120-159 mm Hg and diastolic BP 80-95 mm Hg were randomly assigned to receive the DASH diet or a typical American (control) diet, consuming three different sodium intakes (higher=142 mmol/d, intermediate=107 mmol/d, and lower=65 mmol/d) for 30 days each. BP control was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. Among subjects with hypertension at baseline, at higher sodium intake the DASH diet increased BP control two-fold over control (63% vs. 32%; 95% confidence interval, 1.4-2.9). Reducing sodium intake in the control diet group increased BP control 2.3-fold (74% vs. 32%; 95% confidence interval, 1.7-3.2). The maximum BP control rate (84%) was achieved with the DASH/lower sodium diet. BP became normal or optimal in 71% of persons consuming the control/lower sodium diet and 77% of persons consuming the DASH/lower sodium diet. Both the DASH diet and reduced sodium intake improved BP control.

Figures

Figure 1

End‐of‐feeding blood pressure (BP) control rates (%) by diet and sodium level for Dietary Approaches to Stop Hypertension (DASH)‐Sodium trial participants who were hypertensive (HTN) at baseline (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) and in those who had isolated systolic hypertension (ISH) at baseline (systolic BP ≥140 mm Hg and diastolic BP <90 mm Hg). H=higher sodium level (142 mmol/d); I=intermediate sodium level (107 mmol/d); L=lower sodium level (65 mmol/d); *p<0.01 compared with control diet at higher sodium level;†p<0.05 compared with DASH diet at higher sodium level; **BP control was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg.

Figure 2

Mean end‐of‐feeding systolic blood pressure (BP) (mm Hg) of 155 participants with hypertension by diet and sodium level. For effect of sodium *p<0.05,†p<0.0001 within diet group, for effect of Dietary Approaches to Stop Hypertension (DASH) diet‡p<0.0001††p<0.05 between diet groups.

Figure 3

Mean end‐of‐feeding systolic blood pressure (BP) (mm Hg) of 77 participants with isolated systolic hypertension, by diet and sodium level. For effect of sodium *p<0.05,†p<0.0001 within diet group and for effect of Dietary Approaches to Stop Hypertension (DASH) diet‡p<0.0001,††p<0.05 between diet groups.

Figure 4

Blood pressure (BP) category at end of intervention in participants with high‐normal BP at baseline. Among the 131 Dietary Approaches to Stop Hypertension‐Sodium trial participants with high‐normal BP at baseline, the percent who had optimal (systolic BP

Figure 5

Mean end‐of‐feeding systolic blood pressure (BP) (mm Hg) of 131 participants with high‐normal BP, by diet and sodium level. For effect of sodium *p<0.05,†p<0.0001 within diet group and for effect of Dietary Approaches to Stop Hypertension (DASH) diet‡p<0.0001,‡p<0.05 between diet groups.