Current Atherosclerosis Reports

, Volume 5, Issue 6, pp 484–491 | Cite as

The DASH diet and blood pressure

  • Shirley R. Craddick
  • Patricia J. Elmer
  • Eva Obarzanek
  • William M. Vollmer
  • Laura P. Svetkey
  • Martha C. Swain

Abstract

High blood pressure (also called hypertension) is one of the most important and common risk factors for atherosclerotic cardiovascular disease (CVD) and other chronic diseases. National guidelines recommend that all individuals with blood pressure readings of 120/80 mm Hg or higher adopt healthy lifestyle habits, including the Dietary Approaches to Stop Hypertension (DASH) diet, to manage their blood pressure. The DASH diet, which is high in fruits, vegetables, and low-fat dairy products and reduced in fat, has been shown in large, randomized, controlled trials to reduce blood pressure significantly. The DASH diet also has been shown to reduce blood cholesterol and homocysteine levels and to enhance the benefits of antihypertensive drug therapy. The DASH diet should be promoted, along with maintaining healthy weight, reducing sodium intake, increasing regular physical activity, and limiting alcohol intake, for lowering blood pressure and reducing the risk of CVD.

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References

  1. 1.
    Lenfant C, Chobanian AV, Jones DW, Roccella EJ: Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails. Circulation 2003, 107:2993–2994.CrossRefGoogle Scholar
  2. 2.
    Wolz M, Cutler J, Roccella EJ, et al.: Statement from the National High Blood Pressure Education Program: prevalence of hypertension. Am J Hypertens 2000, 13:103–104.PubMedCrossRefGoogle Scholar
  3. 3.
    Stamler J, Stamler R, Neaton JD: Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med 1993, 153:598–615.PubMedCrossRefGoogle Scholar
  4. 4.
    Vasan RS, Larson MG, Leip EP, et al.: Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001, 345:1291–1297.PubMedCrossRefGoogle Scholar
  5. 5.
    Chobanian AV, Bakris GL, Black HR, et al.: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003, 289:2560–2572.PubMedCrossRefGoogle Scholar
  6. 6.
    Sacks FM, Svetkey LP, Vollmer WM, et al.: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001, 344:3–10.PubMedCrossRefGoogle Scholar
  7. 7.
    Sacks FM, Rosner B, Kass EH: Blood pressure in vegetarians. Am J Epidemiol 1974, 100:390–398.PubMedGoogle Scholar
  8. 8.
    Rouse IL, Beilin LJ, Armstrong BK, Vandongen R: Blood-pressure-lowering effect of a vegetarian diet: controlled trial in normotensive subjects. Lancet 1983, 1:5–10.PubMedCrossRefGoogle Scholar
  9. 9.
    Appel LJ, Moore TJ, Obarzanek E, et al.: A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997, 336:1117–1124.PubMedCrossRefGoogle Scholar
  10. 10.
    Sacks FM, Obarzanek E, Windhauser MM, et al.: Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann. Epidemiol 1995, 5:108–118.PubMedCrossRefGoogle Scholar
  11. 11.
    Karanja NM, Obarzanek E, Lin PH, et al.: Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension Trial. DASH Collaborative Research Group. J Am Diet Assoc 1999, 99:S19-S27.PubMedCrossRefGoogle Scholar
  12. 12.
    Lin PH, Windhauser MM, Plaisted CS, et al.: The Linear Index Model for establishing nutrient goals in the Dietary Approaches to Stop Hypertension trial. DASH Collaborative Research Group. J Am Diet Assoc 1999, 99:S40-S44.PubMedCrossRefGoogle Scholar
  13. 13.
    Moore TJ, Vollmer WM, Appel LJ, et al.: Effect of dietary patterns on ambulatory blood pressure: results from the Dietary Approaches to Stop Hypertension (DASH) Trial. DASH Collaborative Research Group. Hypertension 1999, 34:472–477.PubMedGoogle Scholar
  14. 14.
    Svetkey LP, Simons-Morton D, et al.: Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Arch Intern Med 1999, 159:285–293.PubMedCrossRefGoogle Scholar
  15. 15.
    Svetkey LP, Sacks FM, Obarzanek E, et al.: The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-sodium): rationale and design. DASH-Sodium Collaborative Research Group. J Am Diet Assoc 1999, 99:S96-S104.PubMedCrossRefGoogle Scholar
  16. 16.
    Vollmer WM, Sacks FM, Ard J, et al.: Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial. Ann Intern Med 2001, 135:1019–1028.PubMedGoogle Scholar
  17. 17.
    Vollmer WM, Sacks FM, Svetkey LP: New insights into the effects on blood pressure of diets low in salt and high in fruits and vegetables and low-fat dairy products. Curr Control Trials Cardiovasc Med 2001, 2:71–74.PubMedCrossRefGoogle Scholar
  18. 18.
    Miller ER III, Erlinger TP, Young DR, et al.: Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT). Hypertension 2002, 40:612–618.PubMedCrossRefGoogle Scholar
  19. 19.
    Svetkey LP, Harsha DW, Vollmer WM, et al.: Premier: a clinical trial of comprehensive lifestyle modification for blood pressure control: rationale, design and baseline characteristics. Ann Epidemiol 2003, 13:462–471.PubMedCrossRefGoogle Scholar
  20. 20.
    Writing Group of the PREMIER Collaborative Research Group: Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003, 289:2083–2093.CrossRefGoogle Scholar
  21. 21.
    The Trials of Hypertension Prevention Collaborative Research Group: Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. Arch Intern Med 1997, 157:657–667.CrossRefGoogle Scholar
  22. 22.
    Conlin PR, Erlinger TP, Bohannon A, et al.: The DASH diet enhances the blood pressure response to losartan in hypertensive patients. Am J Hypertens 2003, 16:337–342.PubMedCrossRefGoogle Scholar
  23. 23.
    Svetkey LP, Moore TJ, Simons-Morton DG, et al.: Angiotensinogen genotype and blood pressure response in the Dietary Approaches to Stop Hypertension (DASH) study. J Hypertens 2001, 19:1949–1956.PubMedCrossRefGoogle Scholar
  24. 24.
    US Department of Agriculture (USDA), US Department of Health and Human Services: Nutrition and Your Health: Dietary Guidelines for Americans. Aim for Fitness Build a Healthy Base. Aim for Fitness Build a Healthy Base Choose Sensibly. Fifth Edition 2000 No. 232. 2000.Google Scholar
  25. 25.
    NHLBI, National Cholesterol Education Program: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. [No. 02-5215]. Washington, DC: NIH Publication; 2002.Google Scholar
  26. 26.
    Krauss RM, Eckel RH, Howard B, et al.: AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 2000, 102:2284–2299.PubMedGoogle Scholar
  27. 27.
    Obarzanek E, Sacks FM, Vollmer WM, et al.: Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr 2001, 74:80–89.PubMedGoogle Scholar
  28. 28.
    Appel LJ, Sacks FM, Harsha D, et al.: The effects of sodium reduction on blood lipids; results from the DASH-Sodium feeding study [abstract]. Hypertension 2003, in press.Google Scholar
  29. 29.
    Boushey CJ, Beresford SA, Omenn GS, Motulsky AG: A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995, 274:1049–1057.PubMedCrossRefGoogle Scholar
  30. 30.
    Clarke R, Armitage J: Vitamin supplements and cardiovascular risk: review of the randomized trials of homocysteine-lowering vitamin supplements. Semin Thromb Hemost 2000, 26:341–348.PubMedCrossRefGoogle Scholar
  31. 31.
    Verhaar MC, Stroes E, Rabelink TJ: Folates and cardiovascular disease. Arterioscler Thromb Vasc Biol 2002, 22:6–13.PubMedCrossRefGoogle Scholar
  32. 32.
    Appel LJ, Miller ER III, Jee SH, et al.: Effect of dietary patterns on serum homocysteine: results of a randomized, controlled feeding study. Circulation 2000, 102:852–857.PubMedGoogle Scholar
  33. 33.
    Parks EJ, Hellerstein MK: Carbohydrate-induced hypertriacylglycerolemia: historical perspective and review of biological mechanisms. Am J Clin Nutr 2000, 71:412–433.PubMedGoogle Scholar
  34. 34.
    Cook NR, Cohen J, Hebert PR, et al.: Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 1995, 155:701–709.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2003

Authors and Affiliations

  • Shirley R. Craddick
    • 1
  • Patricia J. Elmer
    • 1
  • Eva Obarzanek
    • 1
  • William M. Vollmer
    • 1
  • Laura P. Svetkey
    • 1
  • Martha C. Swain
    • 1
  1. 1.Kaiser Permanente Center for Health ResearchPortlandUSA

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