Hypertension: food does better than drugs to lower blood pressure

Combining a low-salt diet with the ‘cardioprotective’ principles of the DASH diet is found to be more effective than taking antihypertensive drugs effective in lowering systolic blood pressure, according to a new intervention study.

The DASH (Dietary Approaches to Stop Hypertension) diet, long promoted by the National Heart, Lung, and Blood Institute and the American Heart Association, is rich in fruits, vegetables, whole grains, lean dairy products, fish, poultry, legumes, nuts and seeds.

It has already been widely proven to reduce blood pressure, just like a poor diet in salt. The purpose of this new study, conducted at the Johns Hopkins University School of Medicine, was to assess the combined effects of these two approaches in adults with early or mild forms of high blood pressure, i.e. group at high risk of developing a more severe form of hypertension.

DASH diet, less salt and dramatic results on blood pressure

While 12 weeks, 150 adults with a systolic blood pressure (BP) of 120 at 159 mm Hg followed either a DASH diet or a control diet, close to that of the average American population.

Sodium intake was modified randomly for periods four weeks, with low (1150 mg of sodium per day), medium (1150 mg/d) or high (3450 mg/d). Participants were categorized into groups based on their baseline systolic PS.

Results, published in the Journal of the American College of Cardiology, show that the DASH diet leads to a reduction in PS which is all the more important as the starting PS was high. The most dramatic results, however, appear for the combination of the DASH diet and a low sodium intake.

More effective than antihypertensive drugs

Thus, while the DASH diet alone reduced systolic PS by only 4 mm Hg in those with the lowest baseline PS (93-129 mm Hg), the reduction is 15 mm Hg in those with a PS of 150 to 159 mm Hg.

And when those with the highest starting PS combine DASH diet and low sodium intake, it is a mean reduction of 17 mm Hg, compared to the control diet.

To situate the importance of these results, the authors explain that the Food and Drug Administration requires, for any new antihypertensive drug submitted for approval, a reduction in PS systol ic of 3-4 mm Hg. And that the most commonly used drugs, beta-blockers, reduce systolic PS on average by -15 mm Hg.

Source

Juraschek S et al. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. J Am Coll Cardiol;50(23): 2841-3450.

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