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(Hypertension. 1999;34:472-477.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Effect of Dietary Patterns on Ambulatory Blood Pressure
Results From the Dietary Approaches to Stop Hypertension (DASH) Trial
From the Department of Medicine, Brigham and Women's Hospital (T.J.M., F.M.S., P.R.C.), Boston, Mass; Merck and Company (T.J.M.), Westwood, Mass; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University (L.J.A.), Baltimore, Md; Duke University Medical Center, Duke Hypertension Center (L.P.S.), Durham, NC; Department of Nutrition, Harvard School of Public Health (F.M.S.), Boston, Mass; Kaiser Permanente Center for Health Research (T.M.V., W.M.V.), Portland, Ore; Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute (D.G.S.-M.), Bethesda, Md; Department of Epidemiology (L.C.-E.), University of North Carolina at Chapel Hill; Pennington Biomedical Research Center (D.W.H.), Baton Rouge, La; and Kaiser-Permanente Center for Health Research (T.M.V.), Honolulu, Hawaii.
Correspondence to Thomas J. Moore, MD, Suite 365, 690 Canton St, Westwood, MA 02090. E-mail thomas_moore{at}merck.com
Abstract—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.
Key Words: blood pressure monitoring, ambulatory • nutrition • diet • blood pressure
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