Ambulatory blood pressure in the dash diet trial: Effects of race and albuminuria

Tyson, Crystal C.; Barnhart, Huiman X.; Sapp, Shelly; Sanjabi, Shomyseh; Lin, Pao‐Hwa; Svetkey, Laura P.

doi:10.1111/jch.13170

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…A few feeding trials in hypertensive patients have shown that the DASH diet affects the “around-the-clock” reduction in BP, which was assessed by ambulatory blood pressure (ABP) monitoring over a 24-h period ( 15–17 ). Some studies reported a similar effect on nighttime BP, which was measured as the nighttime mean BP ( 15 , 17 ), hour by hour mean nighttime BP ( 15 ), or nighttime BP dipping as seen in African Americans ( 18 ) and participants with low-grade albuminuria ( 17 ). There is still a lack of data relating the DASH diet with other BP metrics, including BP variability.…”

Section: Introductionmentioning

confidence: 94%

Dietary Approaches to Stop Hypertension (DASH)-Style Dietary Pattern and 24-Hour Ambulatory Blood Pressure in Elderly Chinese with or without Hypertension

Wang

Zhang

et al. 2022

The Journal of Nutrition

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Background It is unknown whether the Dietary Approaches to Stop Hypertension (DASH) is associated with other blood pressure variables, beyond mean systolic (SBP) and diastolic blood pressures (DBP). Objectives The study aimed to study the associations between the DASH dietary pattern and daytime and nighttime mean BPs and BP variability independent of mean (VIM). Methods A sample of 324 Chinese adults aged ≥ 60 years who were not on BP-lowering medications were included in the analysis. The DASH score was calculated using data collected by a validated food frequency questionnaire. The 24-hour ambulatory BP was measured and the mean, SBP VIM and DBP VIM were calculated for both the daytime (0600 h – 2159 h) and nighttime periods (2200 h – 0559 h). Multivariable linear models were constructed to assess associations between the DASH dietary pattern and daytime and nighttime BP outcomes, adjusting for socio-demographic factors, lifestyle, body mass index, and hypertension (clinic SBP ≥ 140 mmHg or DBP ≥ 90 mmHg), and sleep parameters (only for nighttime BP outcomes). An interaction term between DASH score and hypertension status was added to explore the potential differential association in normotensive and hypertensive individuals. Results Every 1 unit increase in the DASH score was associated with a 0.18 unit (95%CI: −0.34, −0.01 unit) and a 0.22 unit (95%CI: –0.36, –0.09 unit) decrease in nighttime VIM SBP and nighttime VIM DBP, respectively. DASH score was not associated with any daytime BP outcomes, nighttime mean SBP, or nighttime mean DBP. A significant interaction (DASH score X hypertension status) was detected for VIM SBP (p-interaction = 0.04), indicating differential association between DASH score and nighttime VIM SBP by hypertension status. Conclusions Independent of sleep parameters and other factors, DASH dietary pattern is associated with lower nighttime blood pressure variability in elderly adults.

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Section: Introductionmentioning

confidence: 94%

Dietary Approaches to Stop Hypertension (DASH)-Style Dietary Pattern and 24-Hour Ambulatory Blood Pressure in Elderly Chinese with or without Hypertension

Wang

Zhang

et al. 2022

The Journal of Nutrition

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“…The BP-lowering effect of RIC is comparable to the BP-lowering effect of lifestyle modifications, as shown in previous clinical trials. 18,[23][24][25][26][27][28] Previous studies have shown that exercise training reduces 24-hour average SBP/ DBP by 5.4/3.0 mm Hg, 25 and the Dietary Approaches to Stop Hypertension diet decreases 24-hour average SBP/DBP by 3.5/2.9 mm Hg, 28 compared with the reduction in the control group. In this trial, we found that the 24-hour average SBP/DBP reduced by 3.6/2.7 mm Hg in the ITT analysis and 5.3/3.5 mm Hg in the PP analysis after 4 weeks of treatment with RIC compared with the reduction in the control group.…”

Section: Discussionmentioning

confidence: 99%

Chronic Remote Ischemic Conditioning on Mild Hypertension in the Absence of Antihypertensive Medication: A Multicenter, Randomized, Double-Blind, Proof-of-Concept Clinical Trial

et al. 2023

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Background: Exploratory studies have shown that remote ischemic conditioning (RIC) has the potential to lower blood pressure (BP). We investigated whether chronic RIC reduces BP for hypertension. Methods: This is a multicenter, randomized, double-blind, parallel-controlled trial. Patients with an office BP of 130/80 to 160/100 mm Hg and a 24-hour average BP ≥125/75 mm Hg not on antihypertensive medications were recruited. After a 1-week compliance screening phase, they were randomly assigned in a 1:1 ratio to receive RIC or sham RIC twice daily for 4 weeks. The primary efficacy outcome was the change in 24-hour average systolic BP from baseline to 4 weeks. Safety events were assessed over the study period. Results: Ninety-five participants were randomly allocated to the RIC (n=49) and sham RIC (n=46) groups. In the intention-to-treat analysis, the reduction in 24-hour average systolic BP was greater in the RIC group than the sham RIC group (−4.6±9.5 versus −0.9±6.8 mm Hg; baseline-adjusted between-group mean difference: −3.6 mm Hg [95% CI, −6.9 to −0.3 mm Hg]; adjusted P =0.035). The per-protocol analysis showed that 24-hour average systolic BP reduced −5.9±8.6 mm Hg in the RIC group and −0.7±6.7 mm Hg in the sham RIC group (baseline-adjusted between-group mean difference: −5.2 mm Hg [95% CI, −8.5 to −1.9 mm Hg]; adjusted P =0.002). No major adverse events were reported in both groups. Conclusions: RIC is safe in patients with mild hypertension and may lower BP in the absence of antihypertensive medications. However, the effects of RIC on clinical outcomes in these patients require further investigation. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04915313.

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“…Study stratification by health outcomes is depicted in Figure 2. 41 , calcitriol (men only) 31 , TC, LDL and HDL 35 , and CHD risk 25 on the DASH diet in Black people compared to Whites. In the DASH-sodium study, the reductions in BP between the lower and higher sodium levels on the control diet were greater in Black people versus Whites 47 .…”

Section: Effects Of Dietary Intervention On Health Outcomes By Race or Ethnicitymentioning

confidence: 98%

A Systematic Review of Literature on Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions

Dhillon¹,

Jacobs²,

Ortiz³

et al. 2021

Preprint

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There is a disproportionate increase in the incidence of diet-related cardiometabolic disorders in racial and ethnic minority groups. This systematic review examines the extent to which diet-induced changes in health outcomes have been discussed by race or ethnicity in randomized controlled trials recruiting both minority and non-Hispanic White groups. Databases i.e. PubMed, Cochrane library and Web of Science were searched up to November 2019. Studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group vs. non-Hispanic Whites (n=29) were included in the review. Most studies were conducted in Black vs. White people testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black people compared to Whites particularly on DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability in most studies. Adequately powered studies are needed for accurate interpretation of race by diet effects. With emerging precision nutrition initiatives, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing nutrition-related health disparities.

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Ambulatory blood pressure in the dash diet trial: Effects of race and albuminuria

Abstract: We evaluated whether low-grade albuminuria or black race modulates ambulatory blood pressure (BP) or nocturnal BP response to the DASH diet. Among 202 adults enrolled in the DASH multicenter trial who were fed the DASH or control diet for

Cited by 8 publications

References 37 publications

Dietary Approaches to Stop Hypertension (DASH)-Style Dietary Pattern and 24-Hour Ambulatory Blood Pressure in Elderly Chinese with or without Hypertension

Dietary Approaches to Stop Hypertension (DASH)-Style Dietary Pattern and 24-Hour Ambulatory Blood Pressure in Elderly Chinese with or without Hypertension

Chronic Remote Ischemic Conditioning on Mild Hypertension in the Absence of Antihypertensive Medication: A Multicenter, Randomized, Double-Blind, Proof-of-Concept Clinical Trial

A Systematic Review of Literature on Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions

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