Adherence to the Dietary Approaches to Stop Hypertension (DASH) and hypertension risk: results of the Longitudinal Study of Adult Health (ELSA-Brasil)

Abstract

We investigated whether high adherence to the Dietary Approaches to Stop Hypertension (DASH) diet was independently associated with lower risk of incident hypertension. Participants included 5632 adults, without hypertension at the baseline (2008–2010) of the Longitudinal Study of Adult Health, who took part in the second follow-up visit (2012–2014). Adherence to the DASH diet was estimated at baseline using a score based on eight food items (final scores from 8 to 40 points) and was categorised as high adherence (≥30 points, or ≥75 %) and low adherence (<75 %; reference). Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg, or use of antihypertensive drugs. The association between adherence to the DASH diet and the risk of incident hypertension was estimated using Cox regression models adjusted by covariates. In total, 780 new cases of hypertension (13·8 %) were identified in about 3·8-year follow-up. Participants with high adherence to the DASH diet had 26 % lower risk of hypertension (hazard ratio (HR) 0·74; 95 % CI 0·57, 0·95) after adjustment for socio-demographic characteristics, health-related behaviours, diabetes and family history of hypertension. The HR reduced to 0·81 (95 % CI 0·63, 1·04) and was of borderline statistical significance after adjustment for BMI, suggesting that lower body weight explains about 10 % of the association between high adherence to the DASH diet and hypertension risk reduction. The results indicate that high adherence to the DASH diet lowered the risk of hypertension by one-fourth over a relatively short follow-up period.

Association of Dietary Patterns with Cardiovascular and Kidney Phenotypes in an Uruguayan Population Cohort

“…On the other hand, other studies found a negative association between a “Healthy” DP (such as the Prudent DP) and systolic BP, and lower occurrence of hypertension [ 32 ]. A recent longitudinal study in Brazil reported the protective effect of following a DP characterized by healthy food selection [ 58 ] in incident hypertension. Moreover, it found that body weight explained as much as 10% in the reduction risk of high BP.…”

Healthy eating index 2015 and major dietary patterns in relation to incident hypertension; a prospective cohort study

“…A systematic review and meta-analysis on 30 randomized clinical trials observed that adherence to the DASH diet can significantly lower blood pressure in hypertensive and healthy adults [ 40 ]. Francisco et al, in their study, reported that adherence to the DASH diet was associated with a significant reduction in blood pressure, even with a short follow-up period [ 41 ]. Legumes, fruits and vegetables are enriched antioxidants and essential vitamins, including fibre, vitamin C, potassium, folic acid, magnesium, flavonoids, and carotenoids, and have synergistic effects on lowering blood pressure by improving endothelial function and their antioxidative properties causing vasodilation [ 42 , 43 ].…”

Association of adherence to the dietary approach to stop hypertension and Mediterranean diets with blood pressure in a non-hypertensive population: Results from Isfahan Salt Study (ISS)

“…In another RCT, Juraschek et al evaluated the effects of low versus high sodium, DASH versus control, and both (low sodium-DASH vs. high sodium-control diets) on SBP and found that the combination of reduced sodium intake and the DASH diet has lowered SBP throughout the range of pre-and stage 1 hypertension [42]. In two large cohort studies, adherence to the DASH dietary pattern was related to lower levels of DBP after 10 years of follow-up [43,44], while another recent longitudinal study associated adherence to the DASH diet with 26% lower risk of developing hypertension [45]. On the contrary to these findings, Divens et al [46] did not find any significant changes in SBP and DBP in African American women who followed the DASH dietary pattern for one year.…”