DASH (Dietary Approaches to Stop Hypertension) diet is effective treatment for stage 1 isolated systolic hypertension

Use of the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, and low-fat dairy foods, significantly lowers blood pressure. Among the 459 participants in the DASH Trial, 72 had stage 1 isolated systolic hypertension (ISH) (systolic blood pressure, 140 to 159 mm Hg; diastolic blood pressure, <90 mm Hg). We examined the blood pressure response in these 72 participants to determine whether the DASH diet is an effective treatment for stage 1 ISH. After a 3-week run-in period on a typical American (control) diet, participants were randomly assigned for 8 weeks to 1 of 3 diets: a continuation of the control diet (n=25), a diet rich in fruits and vegetables (n=24), or the DASH diet (n=23). Sodium content was the same in the 3 diets, and caloric intake was adjusted during the trial to prevent weight change. Blood pressure was measured at baseline and at the end of the 8-week intervention period with standard sphygmomanometry. Use of the DASH diet significantly lowered systolic blood pressure compared with the control diet (-11.2 mm Hg; 95% confidence interval, -6.1 to -16.2 mm Hg; P<0.001) and the fruits/vegetables diet (-8.0 mm Hg; 95% confidence interval, -2.5 to -13.4 mm Hg; P<0.01). Overall, blood pressure in the DASH group fell from 146/85 to 134/82 mm Hg. Similar results were observed with 24-hour ambulatory blood pressure measurements. In the DASH diet group, 18 of 23 participants (78%) reduced their systolic blood pressure to <140 mm Hg, compared with 24% and 50% in the control and fruits/vegetables groups, respectively. Our results indicate that the DASH diet, which is rich in fruits, vegetables, and low-fat dairy foods, is effective as first-line therapy in stage 1 ISH.     

The effect of dietary patterns on blood pressure control in hypertensive patients: results from the Dietary Approaches to Stop Hypertension (DASH) trial

To determine the impact of dietary patterns on the control of hypertension we studied the subgroup of 133 participants with systolic blood pressure (BP) of 140 to 159 mm Hg and/or diastolic BP of 90 to 95 mm Hg enrolled in the Dietary Approaches to Stop Hypertension (DASH) study. Participants were fed a control diet for a 3-week period and were then randomized to receive for 8 weeks either the control diet; a diet rich in fruits and vegetables, but otherwise similar to control; or a combination diet rich in fruits, vegetables, and low-fat dairy products, including whole grains, fish, poultry, and nuts, and reduced in fats, red meats, sweets, and sugar-containing beverages. Sodium intake and body weight were held constant throughout the study. The combination diet significantly reduced systolic BP (-11.4 mm Hg, P < .001) and diastolic BP (-5.5 mm Hg, P < .001). The fruits-and-vegetables diet also significantly reduced systolic BP (-7.2 mm Hg, P < .001) and diastolic BP (-2.8 mm Hg, P = .013). The combination diet produced significantly greater BP effects (P < .05) than the fruits-and-vegetables diet. Blood pressure changes were evident within 2 weeks of starting the intervention feeding. After the 8-week intervention period, 70% of participants eating the combination diet had a normal BP (systolic BP < 140 and diastolic BP < 90 mm Hg) compared with 45% on the fruits-and-vegetables diet and 23% on the control diet. In patients with hypertension, the DASH combination diet effectively lowers BP and may be useful in achieving control of Stage 1 hypertension.     

Angiotensinogen genotype and blood pressure response in the Dietary Approaches to Stop Hypertension (DASH) study.

OBJECTIVE : To determine the relationship between angiotensinogen (ANG) genotype and blood pressure response to the dietary patterns of the Dietary Approaches to Stop Hypertension (DASH) trial. The angiotensin converting enzyme (ACE) gene was also tested. DESIGN : The DASH trial was a randomized outpatient feeding study comparing the effects on blood pressure (BP) of three dietary patterns: a control diet, similar to typical American intake; a 'fruits and vegetables' diet (F/V) that is rich in fruits and vegetables but otherwise resembles the control diet; and the DASH diet that is reduced in fats and that emphasizes fruits, vegetables and low-fat dairy products. Participants' genotype was also determined. SETTING : Four clinical sites. PARTICIPANTS : Adults with above-optimal BP or stage 1 hypertension. INTERVENTION : Participants ate one of the three dietary patterns for 8 weeks. Sodium intake and weight were held constant. In 355 of 459 DASH participants, DNA was extracted from leukocytes and genotyped for the G-6A ANG polymorphism and the D/I ACE polymorphism, by the polymerase chain reaction. MAIN OUTCOMES : Genotype at ANG and ACE loci; BP after 8 weeks of intervention diet. RESULTS : There was no association between ACE genotype and BP response. Associations with ANG polymorphism were significant: net systolic and diastolic BP response to the DASH diet was greatest in individuals with the AA genotype (-6.93/-3.68 mmHg) and least in those with the GG genotype (-2.80/0.20 mmHg). A similar relationship existed for the F/V diet. CONCLUSIONS : ANG genotype is associated with BP response to the DASH diet. The AA genotype confers excess risk of hypertension and is associated with increased responsiveness to diet.     

Effect of dietary patterns on ambulatory blood pressure : results from the Dietary Approaches to Stop Hypertension (DASH) Trial. DASH Collaborative Research Group.

We measured ambulatory blood pressure (ABP) in 354 participants in the Dietary Approaches to Stop Hypertension (DASH) Trial to determine the effect of dietary treatment on ABP (24-hour, day and night) and to assess participants' acceptance of and compliance with the ABP monitoring (ABPM) technique. After a 3-week run-in period on a control "typical" American diet, subjects (diastolic blood pressure [BP], 80 to 95 mm Hg; systolic BP, <160 mm Hg; mean age, 45 years) were randomly assigned to 1 of 3 diets for an 8-week intervention period: a continuation of the control diet; a diet rich in fruits and vegetables; and a "combination" diet that emphasized fruits, vegetables, and low-fat dairy products. We measured ABP at the end of the run-in and intervention periods. Both the fruit/vegetable and combination diets lowered 24-hour ABP significantly compared with the control diet (P<0. 0001 for systolic and diastolic pressures on both diets: control diet, -0.2/+0.1 mm Hg; fruit/vegetable diet, -3.2/-1.9 mm Hg; combination diet, -4.6/-2. 6 mm Hg). The combination diet lowered pressure during both day and night. Hypertensive subjects had a significantly greater response than normotensives to the combination diet (24-hour ABP, -10.1/-5.5 versus -2.3/-1.6 mm Hg, respectively). After correction for the control diet responses, the magnitude of BP lowering was not significantly different whether measured by ABPM or random-zero sphygmomanometry. Participant acceptance of ABPM was excellent: only 1 participant refused to wear the ABP monitor, and 7 subjects (2%) provided incomplete recordings. These results demonstrate that the DASH combination diet provides significant round-the-clock reduction in BP, especially in hypertensive participants.     

The effects of dietary patterns on plasma renin activity: results from the Dietary Approaches to Stop Hypertension trial

A diet rich in fruits, vegetables and low-fat dairy products, and reduced in saturated fat, total fat and cholesterol (the 'DASH' diet) significantly lowers blood pressure (BP). Previous studies have documented that certain therapies that lower BP increase plasma renin activity (PRA). Using data from the Dietary Approaches to Stop Hypertension (DASH) trial, we assessed the effects of dietary patterns on PRA and determined the relationship of change in PRA with change in BP on each diet. After eating a control diet for 3 weeks, participants were then randomized to receive for 8 weeks: the control diet, a diet rich in fruits and vegetables (F/V), or the DASH diet. Baseline and follow-up levels of PRA were available in 381 participants. Compared with the control diet, the DASH diet increased PRA by 0.37?ng?ml(-1)?h(-1) (P=0.01). In multivariable linear regression analyses, there was an inverse association of PRA change with systolic BP change on the control diet (slope=-0.35, P=0.001), but PRA did not differ by BP change on the F/V diet (slope=-0.002, P=0.98) or DASH diet (slope=-0.08, P=0.32). These data suggest that a blunted counter-regulatory response of the renin-angiotensin system is associated with the BP-lowering effect of the F/V and DASH diets.     

Fruits and vegetables intake in the SU.VI.MAX study and systolic blood pressure change

BACKGROUND: In intervention studies (DASH), high fruits and vegetables intake lower blood pressure (BP). Less is known on long-term effects of fruits and vegetables intake on BP, especially in European population. OBJECTIVE: To study the relation between fruits and vegetables intake and BP change in the SU.VI.MAX study. METHOD: In the SU.VI.MAX study (1994-2002), BP was measured and information on medical treatment was collected during two clinical examination session in 1995-1996 and 2001-2002. Dietary information came from 24 h dietary records completed every two months, by each volunteer during the first two years of follow-up. We performed a transversal analysis of BP measured at the first clinical examination in 6 427 subjects aged 36-62 years. A longitudinal analysis including subjects without hypertension at baseline was performed on BP change between the two examination (n=2958). RESULTS: At first examination, after adjusting for main confounding factors, subjects reporting high vegetables intake (last quintile) had a lower (-1.6 mmHg, p trend <0.01) systolic BP (SBP) than subjects reporting lower intake (first quintile). High fruits intake was slightly associated with lower SBP (1.1 mmHg, NS). At the end of the follow-up, the mean increase of SBP was of 9.5 mmHg. This increase was 2.2 mmHg lower (p < 0.003) in the last quintile of vegetables intake. No similar relation was observed with fruits intake. CONCLUSION: These results suggest that vegetables intake may be associated with lower BP and a lower increase of BP over years. This last association may have implications for the prevention of hypertension which appears with aging.     

Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial.

BACKGROUND: Initial findings from the Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial demonstrated that reduction of sodium intake in two different diets decreased blood pressure in participants with and without hypertension. OBJECTIVE: To determine effects on blood pressure of reduced sodium intake and the DASH diet in additional subgroups. DESIGN: Randomized feeding study. SETTING: Four clinical centers and a coordinating center. PARTICIPANTS: 412 adults with untreated systolic blood pressure of 120 to 160 mm Hg and diastolic blood pressure of 80 to 95 mm Hg. INTERVENTION: Participants followed the DASH diet or a control (typical U.S.) diet for three consecutive 30-day feeding periods, during which sodium intake (50, 100, and 150 mmol/d at 2100 kcal) varied according to a randomly assigned sequence. Body weight was maintained. MEASUREMENTS: Systolic and diastolic blood pressure. RESULTS: In all subgroups, the DASH diet and reduced sodium intake were each associated with significant decreases in blood pressure; these two factors combined produced the greatest reductions. Among nonhypertensive participants who received the control diet, lower (vs. higher) sodium intake decreased blood pressure by 7.0/3.8 mm Hg in those older than 45 years of age (P < 0.001) and by 3.7/1.5 mm Hg in those 45 years of age or younger (P < 0.05). CONCLUSION: The DASH diet plus reduced sodium intake is recommended to control blood pressure in diverse subgroups.     

Effect of dietary sodium intake on blood lipids: results from the DASH-sodium trial

We evaluated the effect on serum lipids of sodium intake in 2 diets. Participants were randomly assigned to a typical American control diet or the Dietary Approaches to Stop Hypertension (DASH) diet, each prepared with 3 levels of sodium (targeted at 50, 100, and 150 mmol/d per 2100 kcal). The DASH diet is increased in fruits, vegetables, and low-fat dairy products and is reduced in saturated and total fat. Within assigned diet, participants ate each sodium level for 30 days. The order of sodium intake was random. Participants were 390 adults, age 22 years or older, with blood pressure of 120 to 159 mm Hg systolic and 80 to 95 mm Hg diastolic. Serum lipids were measured at baseline and at the end of each sodium period. Within each diet, sodium intake did not significantly affect serum total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides. On the control diet, the ratio of total cholesterol-to-HDL cholesterol increased by 2% from 4.53 on higher sodium to 4.63 on lower sodium intake (P=0.04). On the DASH diet, sodium intake did not affect this ratio. There was no dose-response of sodium intake on serum lipids or the cholesterol ratio in either diet. At each sodium level, total cholesterol, LDL cholesterol, and HDL cholesterol were lower on the DASH diet versus the typical American diet. There were no significant interactions between the effects of sodium and the DASH diet on serum lipids. In conclusion, changes in dietary sodium intake over the range of 50 to 150 mmol/d did not affect blood lipid concentrations.     

Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship

Blood pressure-lowering mechanisms of the Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy foods, were analyzed based on the pressure-natriuresis relationship. Participants (n=375) were randomly assigned to control or DASH diet groups by using a parallel-group design. They then ate their assigned diet for 3 consecutive 30-day intervention feeding periods, during which sodium intake varied among 3 levels by a randomly assigned sequence. Urinary sodium excretion rate and mean arterial pressure were measured at the end of each sodium intake level. Mean arterial pressure and urinary sodium excretion were plotted on x and y axes, respectively, for participants eating control and DASH diets and were modeled as linear relationships for simplicity to allow the estimation of the extrapolated x-intercept and slope of the relationships. The DASH diet steepened the slope of the relationship (29.5+/-3.4 vs 64.9+/-13.1 [mmol/d]/mm Hg, P=0.0002) without significantly shifting the x-intercept (94.1+/-0.5 vs 93.2+/-0.6 mm Hg, NS) of the relationship. These data suggest a natriuretic action of the DASH diet.     

Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: A systematic review and meta-analysis on randomized controlled trials

Background and aimsFindings were not consistent on the therapeutic effect of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure. We aimed to review systematically and perform a meta-analysis to assess the magnitude of the effect of the DASH diet on blood pressure in randomized controlled trials (RCTs) among adults.Methods and resultsWe conducted a systematic review and random effects meta-analysis of all RCTs which evaluated the effect of the DASH diet on blood pressure including published papers until June 2013, using PubMed, ISI Web of Science, Scopus and Google scholar database. Subgroup analysis and meta-regression were used to find out possible sources of between-study heterogeneity. Seventeen RCTs contributing 20 comparisons with 2561 participants were included. Meta-analysis showed that the DASH diet significantly reduced systolic blood pressure by 6.74 mmHg (95%CI: −8.25, −5.23, I² = 78.1%) and diastolic blood pressure by 3.54 mmHg (95%CI: −4.29, −2.79, I² = 56.7%). RCTs with the energy restriction and those with hypertensive subjects showed a significantly greater decrease in blood pressure. Meta-regression showed that mean baseline of SBP and DBP was explained 24% and 49% of the variance between studies for SBP and DBP, respectively.ConclusionThe results revealed the profitable reducing effect of the DASH-like diet on both systolic and diastolic blood pressure in adults; although there was a variation in the extent of the fall in blood pressure in different subgroups.     

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

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.     

Antihypertensive effect of valsartan 80 mg and hydrochlorothiazide 12.5 mg evaluated by ambulatory blood pressure monitoring

OBJECTIVE: The aim of the study was to evaluate by ambulatory blood pressure measurement (ABPM) the 24 hours antihypertensive efficacy of the fixed combination therapy, valsartan 80 mg + hydrochlorothiazide 12.5 mg (V + H), once daily, after 6 weeks of treatment, in patients with mild to moderate hypertension. STUDY DESIGN: It was a French, multicenter, double blind, randomized trial in parallel groups comparing V + H and placebo. After an initial two weeks placebo period, patients were assigned to receive either V + H or placebo for six weeks. Were eligible those with clinical arterial blood pressure, measured by sphygmomanometer, between 160/95 and 209/114 mmHg after monotherapy. A 26 hours ABPM, with Spacelabs 90,207, was done at J0 and J42 (one measurement every 15 minutes, in day time and at night). Responders were defined as a fall in day diastolic blood pressure > or = 5 mmHg and/or day diastolic blood pressure < 90 mmHg with ABPM. RESULTS: 123 of the 138 randomized patients had two interpretative measurements. Their average age was 59 + 10 years. 57% (78) of them were males and their average ABPM before treatment was 143 +/- 15/88 +/- 11 mmHg. With V + H, the reduction of the systolic and the diastolic blood pressure measured by ABPM, was significantly more important than with placebo (SBP: -15.4 +/- 10.9 mmHg versus -0.6 +/- 7.7 mmHg, p < 0.001; DBP: -9.1 +/- 7 mmHg versus -0.4 +/- 5.4 mmHg, p < 0.001). Pulse pressure (PP) was also significantly reduced with the combination therapy V + H, but it was not modified with placebo (-6.3 + 5.5 mmHg versus -0.2 + 4.1 mmHg, p < 0.001). ABPM responder rate was 73% with V + H versus 24% with placebo (p < 0.001). Trough/peak ratio was 80.3% for systolic blood pressure and 57.3% for diastolic blood pressure. The combination V + H was as well tolerated as placebo. CONCLUSION: The fixed combination V + H used for treatment of hypertension, after failure of monotherapy, is very effective in reducing pulse pressure, systolic and diastolic blood pressure, over 24 hours, homogeneously, and is as well tolerated as placebo.     

Results of the Diet,Exercise, and Weight Loss Intervention Trial (DEW-IT)

National guidelines for the prevention and treatment of hypertension recommend sodium reduction, weight loss, the Dietary Approach to Stop Hypertension (DASH) diet, and regular aerobic exercise. However, no trial has assessed the efficacy of simultaneously implementing all of these recommendations. The objective of this study was to determine the effects on blood pressure and other cardiovascular disease risk factors of a comprehensive lifestyle intervention. We conducted a randomized controlled trial of 44 hypertensive, overweight adults on a single blood pressure medication. Participants were randomized to a lifestyle or control group. For 9 weeks, the lifestyle group was fed a hypocaloric version of the DASH diet that provided 100 mmol/d of sodium. This group also participated in a supervised, moderate-intensity exercise program 3 times per week. The control group received no intervention. Outcomes were ambulatory blood pressure, serum lipids, weight, and fitness. At the end of the intervention, mean weight loss in the lifestyle group, net of control, was 4.9 kilograms. In the lifestyle group mean net reductions in 24-hour ambulatory systolic and diastolic blood pressures were 9.5 mm Hg (P<0.001) and 5.3 mm Hg (P<0.002), respectively. Corresponding changes in daytime systolic and diastolic blood pressures were 12.1 mm Hg (P<0.001) and 6.6 mm Hg (P<0.001). The lifestyle group experienced mean reductions in total cholesterol (-25 mg/dL, P<0.001), low-density lipoprotein cholesterol (-18 mg/dL, P=0.005), high-density lipoprotein cholesterol (-5 mg/dL, P<0.001), net of control. In conclusion, among hypertensive overweight adults already on antihypertensive medication, a comprehensive lifestyle intervention can substantially lower blood pressure and improve blood pressure control.     

Treatment of isolated systolic hypertension: the SHELL study results

OBJECTIVE: Our aim was to compare the effect of lacidipine and chlorthalidone on cardiovascular outcome as a primary parameter and blood pressure as a secondary in elderly patients with isolated systolic hypertension in a prospective study with an open design. METHODS: 1882 males and females outpatients > or = 60 years were randomly assigned to the administration of chlorthalidone 12.5 mg o.d. or lacidipine 4 mg o.d. Patients were recruited if sitting systolic blood pressure was > or = 160 mmHg with a diastolic blood pressure equal or lower than 95 mmHg. Primary endpoint was a composite of cardiovascular and cerebrovascular events. RESULTS: At randomization mean systolic blood pressure was 178.1 mmHg in the lacidipine and 178.2 mmHg in the chlorthalidone group, the corresponding mean diastolic values being 86.9 and 86.8 mmHg. In both lacidipine and chlorthalidone groups treatment caused a significant (p < 0.001) and marked systolic blood pressure reduction which was maintained throughout the treatment period with a significant (p < 0.001) and steady although less marked reduction in diastolic blood pressure as well. At the end of treatment period (median 32 months), the reduction was 36.8/8.1 mmHg (systolic/diastolic) in the chlorthalidone and 38.4/7.9 mmHg in the lacidipine group, the final on treatment blood pressures being 142.0/79.2 and 143.2/79.5 mmHg, respectively. Treatments were similarly effective in males and females and in age groups between 60 and 69 years (n = 763), 70 and 79 years (n = 744) and > or = 80 years (n = 375). Similar reductions were obtained in a subgroup of patients (n = 209) followed in double-blind fashion for 1 year. The overall incidence of the primary endpoints was 9.3% with no significant between-group difference. Total mortality was also similar between groups. CONCLUSIONS: In elderly patients with isolated systolic hypertension, administration of lacidipine or chlorthalidone markedly reduced systolic blood pressure with no difference in the incidence of cardiovascular events and total mortality.     

Efficacy and safety of a short-time orlistat treatment in obese subjects

Obesity is frequently associated with a high cardiovascular risk. The aim of this study was to assess safety, tolerability and efficacy of orlistat treatment in comparison with placebo in the reduction of body weight in obese subjects and the related cardiovascular risk factors. For such a purpose, 146 obese patients were randomly assigned to two treatments over a period of 27 weeks: 1) hypocaloric diet, exercise and placebo (n = 72); 2) hypocaloric diet, exercise and orlistat 120 mg twice/day (n = 74). The side effects observed were similar for the two treatment groups, with exception of gastrointestinal symptoms, which were significantly more frequent in the orlistat group than in the placebo group. Nevertheless, the side effects were limited and resolved. In fact, none of the patients dropped-out. During the observation period a significantly higher reduction in body weight (-6.9 kg, p < 0.001), systolic blood pressure (-4.9 mmHg, p < 0.001), diastolic blood pressure (-2.9 mmHg, p < 0.001), LDL cholesterol (12.8%, p < 0.001) was observed in the orlistat group than in the placebo group (-4.1 kg, 3.2 mmHg, 1.8 mmHg and 5.1%, respectively). By using a validated questionnaire, in the orlistat group a significantly higher motivation (p < 0.01) to continue diet and exercise than in the placebo group was observed. In addition, at the end of the study, patients receiving orlistat treatment gave a better evaluation of their own image than patients receiving placebo (p < 0.01).     

Anthropometric and dietary determinants of blood pressure in over 7000 Mediterranean women: the European Prospective Investigation into Cancer and Nutrition-Florence cohort

BACKGROUND: Anthropometric characteristics and dietary habits are widely recognized to influence blood pressure. We evaluated their role in a large series of Mediterranean adult women. METHODS: In Florence, in the European Prospective Investigation into Cancer and Nutrition, we recruited 10 083 women, aged 35-64 years. Detailed information on diet, lifestyle, physical activity, and medical history were collected. Anthropometric indices and systolic and diastolic blood pressures were measured at recruitment using standardized procedures. Overall, after excluding those women who reported a clinical diagnosis of hypertension and/or an antihypertensive treatment and those without measurements, 7601 women were available for analyses with an average systolic and diastolic blood pressure value of 123.2+/-16.0 and 78.7+/-9.4 mmHg, respectively. RESULTS: Multivariate regression models showed that body mass index (P<0.0001) and waist circumference (>or=88 cm, P<0.0001), as well as processed meat, potatoes, and wine consumption, were directly associated with both systolic and diastolic values. In contrast, a high consumption of selected foods resulted inversely associated with systolic (total vegetables, yoghurt, and eggs), diastolic (olive oil) or both systolic and diastolic values (leafy vegetables, milk, coffee). Analyses performed on nutrients showed a positive association with alcohol and sodium intake, and an inverse one with potassium and micronutrients derived from fruits and vegetables. CONCLUSION: In this large series of women from Tuscany, Central Italy, we confirm the independent influence of anthropometric characteristics on blood pressure. The role of specific foods and nutrients in modulating blood pressure also emerged, suggesting a central role for lifestyle modifications in blood pressure control.     

The DASH diet enhances the blood pressure response to losartan in hypertensive patients

BackgroundThe Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, and low fat dairy products, significantly lowers blood pressure (BP). We conducted a clinical trial to assess the BP response to the DASH diet with an antihypertensive medication, losartan, in participants with essential hypertension.MethodsA total of 55 hypertensive participants were randomly assigned to 8 weeks of controlled feeding with either a control diet or the DASH diet. Within each diet arm, participants received losartan 50 mg daily or placebo for 4 weeks each, in double blind, randomized, cross-over fashion. Twenty-four-hour ambulatory BP (ABP) was measured at the end of a 2-week run-in period (baseline) and after each 4-week intervention period.ResultsThere was no significant change in ABP during the placebo period on the control diet (n = 28) (−2.3 ± 1.5/−1.6 ± 1.0 mm Hg), but there was a significant reduction in systolic ABP (−5.3 ± 1.5 mm Hg, P < .05) and no change in DBP (−2.5 ± 1.0 mm Hg) on the DASH diet (n = 27). Losartan significantly reduced ABP on the control diet (−6.7 ± 1.5/−3.7 ± 1.0 mm Hg, P < .05) and to a greater extent on the DASH diet (−11.7 ± 1.5/−6.9 ± 1.0 mm Hg, P < .05 versus basal and control diet) particularly in African Americans. On the DASH diet, ΔSBP on losartan was inversely related to basal plasma renin activity (n = −0.53, P = .004).ConclusionsThe DASH diet enhances the ABP response to losartan in essential hypertension. This effect is particularly marked in African Americans.     

Investigating the effect of DASH diet on blood pressure of patients with type 2 diabetes and prehypertension: Randomized clinical trial

Background and objectivesPrehypertension in people with type 2 diabetes is associated with increased risk of cardiovascular disease and lower extremity damages compared to people with normal blood pressure. On the other hand, limited studies have conducted to investigate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes. Therefore, in this study, we aimed to evaluate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes.Materials and methodsIn this clinical trial, 80 patients with diabetes type 2 and prehypertension in the age range of 18–65 years were randomly allocated to intervention (n = 40) and control (n = 40) groups for 12 weeks. The intervention group had DASH diet and the control group received diabetic diet in accordance with the recommendations of the American Diabetes Association (ADA) with 24-h dietary recall; systolic and diastolic blood pressures were measured before and after study.ResultsTaking DASH diet and diabetic diet for 12 weeks caused significant reduction in systolic blood pressure in the intervention group (P value = 0.003). Diastolic blood pressure showed no significant change in none of the two groups.ConclusionFollowing the DASH diet in patients with prehypertension has beneficial effects in improving systolic blood pressure and can be effective to prevent the development of hypertension. Hence, there are needs for long-term interventions with larger sample size in future studies.     

The DASH diet and blood pressure

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.     

Reliability of automatic oscillometric monitoring of arterial pressure. Effect of hypotension and arrhythmias

The object of this study was to assess the reliability of automatic oscillometric monitoring of the systemic blood pressure. The trial was carried out in 4 patients in situations including hypotension and attacks of arrhythmia. The oscillometric pressure measured in the arm was compared with the pressure recorded by an intra-radial arterial catheter in the opposite arm. All patients were in the dorsal decubitus position. One hundred and ten comparative measurements were performed with values ranging from 48 to 200 mmHg for the systolic pressure, 36 to 112 mmHg for the diastolic pressure and 40 to 136 mmHg for mean arterial pressure. A satisfactory correlation was found between the two methods in 91 measurements in sinus rhythm with respect to systolic (r = 0.95, p less than 0.001), diastolic (r = 0.93, p less than 0.001) and mean arterial pressures (r = 0.95 p less than 0.001). The average duration of the measurements was 32 +/- 5 seconds. During the study, one patient developed paroxysmal atrial fibrillation during which 19 comparative measurements of the mean pressure were performed. The correlation between the two methods was not as good as that observed during sinus rhythm (r = 0.73, p less than 0.01) and the average duration of measurement increased significantly (44 +/- 14 seconds). A correlative study was also performed during hypotension. This was defined as directly recorded systolic blood pressures of less than 90 mmHg, diastolic pressures less than 60 mmHg and mean pressures of less than 70 mmHg (n = 40).(ABSTRACT TRUNCATED AT 250 WORDS)