DASH Score and Subsequent Risk of Coronary Artery Disease: The Findings From Million Veteran Program

Djoussé, Luc; Ho, Yuk‐Lam; Nguyen, Xuan‐Mai T.; Gagnon, David; Wilson, Peter W.F.; Cho, Kelly; Gaziano, J. Michael; Halasz, Ildiko; Federman, Daniel G.; Beckham, Jean C.; Sherman, Scott E.; Sriram, Peruvemba; Tsao, Philip S.; Boyko, Edward J.; Xu, Junzhe; Lederle, Frank A.; Dell’Italia, Louis J.; McArdle, Rachel; Kaminsky, Laurence S.; Swann, Alan C.; Hamner, Mark B.; Flórez, Hermes; Pandya, Prashant; Villarreal, Gerardo; Morgan, Timothy R.; Davis, Lori; Hurley, Robin A.; Meyer, Laurence; Ahuja, Sunil K.; Konicki, Eric P.; Cohen, David E.; Lichy, Jack H.; Whittle, Jeff; Haddock, Kathlyn Sue; Straub, K. D.; Callaghan, John T.; Aguayo, Samuel M.; Gupta, Samir; Washburn, Ronald G.; Oehlert, Mary E.; Hung, Adriana M.; Wallbom, Agnes; Keith, Robert; Sonel, Elif; Schifman, Ron B.; Childress, Richard Dale; Godschalk, Michael; Shuldiner, Alan R.; Rastogi, Padmashri; Gutierrez, Salvador; Fernando, Ronald; Iruvanti, Pran; Jhala, Darshana; Rosado‐Rodriguez, Carlos; Mastorides, Stephen; Harley, John B.; Mattocks, Kristin M.; Striker, Rob; Rauchman, Michael; Wells, John A.; Ballas, Zuhair K.; Woods, Susan; Yeh, Shing Shing; Ratcliffe, Nora R.; Klein, Jon B.; Golden, Adam G.; Ginzburg, Harold M.; Sharma, Satish C.; Oursler, Kris Ann; Whooley, Mary A.; Gibson, Gretchen

doi:10.1161/jaha.117.008089

Cited by 33 publications

(22 citation statements)

References 35 publications

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“…[33][34][35] Similarly, the aHEI and DASH diet are associated with reduced mortality and lower rates of several chronic diseases. [9][10][11][12][13][14][15] A healthy diet is also associated with concomitant positive lifestyle factors, such as those seen in our study: less smoking and increased physical activity, both of which are associated with a lower risk of frailty. 1 Because weekly vigorous exercise was included in the frailty index as a proxy for physical inactivity, we did not examine it as a potential confounder.…”

Section: Discussionsupporting

confidence: 59%

“…Similarly, the Dietary Approaches to Stop Hypertension (DASH) score has not been evaluated in terms of its relationship with frailty, despite being associated with lower chronic disease and mortality risk. 10,12,14,15 In this study, we sought to investigate the relationship between self-reported diet quality, measured using three different dietary indices, the aHEI, the DASH dietary assessment, and the MDS, with frailty. We hypothesized that better diet quality would be associated with lower odds of being pre-frail and frail, using two common methods of measuring frailty.…”

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confidence: 99%

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Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Ward

Orkaby

Chen

et al. 2019

J American Geriatrics Society

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OBJECTIVES Limited data suggest that a healthy diet is associated with a lower risk of frailty. We sought to assess the relationship between three measures of diet quality and frailty among male physicians. DESIGN Cross‐sectional analysis of a cohort study. SETTING Physicians’ Health Study. PARTICIPANTS A total of 9861 initially healthy US men, aged 60 years or older, who provided data on frailty status and dietary habits. MEASUREMENTS A cumulative deficit frailty index (FI) was calculated using 33 variables encompassing domains of comorbidity, functional status, mood, general health, social isolation, and change in weight. Diet quality was measured using the Alternative Healthy Eating Index (aHEI), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH). RESULTS The FI identified 38% of physicians as non‐frail, 44% as pre‐frail, and 18% as frail. Multinomial logistic regression models adjusted for age, smoking status, and energy intake showed that compared with the lowest aHEI quintiles, those in the highest quintiles had lower odds of frailty and pre‐frailty compared with non‐frailty (odds ratio [OR] for frailty = .47; 95% confidence interval [CI] = .39‐.58; for pre‐frailty: OR = .75; CI = .65‐.87). Exercise did not modify this association (P interaction >.1). Similar relationships were observed for DASH and MDS quintiles with frailty and pre‐frailty. Restricted cubic splines showed an inverse dose‐response relationship of diet quality scores with odds of frailty and pre‐frailty. CONCLUSION Cross‐sectional data show an inverse dose‐response relationship of diet quality with pre‐frailty and frailty. Future longitudinal studies are needed to investigate whether healthier diet is a modifiable risk factor for frailty. http://clinicaltrials.gov identifier: NCT00000500. J Am Geriatr Soc 68:770–776, 2020

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Section: Discussionsupporting

confidence: 59%

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confidence: 99%

Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Ward

Orkaby

Chen

et al. 2019

J American Geriatrics Society

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“…In a recent longitudinal study of 153,082 US veterans, the DASH diet score was inversely associated with the incidence of coronary artery disease (HR 0.82, 95% CI 0.75–0.89). [ 27 ] Likewise, Niknam et al analyzed the data of 388 hospitalized patients in a case-control study, and found that a DASH-style diet could lower the prevalence of stroke (odds ratio [OR] 0.48, 95% CI 0.24–0.96). [ 28 ] Apart from this, a previous meta-analysis by Salehi-Abargouei et al [ 29 ] also reported an inverse relationship between DASH diet consumption and risk of stroke (RR 0.81, 95% CI 0.72–0.92).…”

Section: Discussionmentioning

confidence: 99%

Adherence to the dietary approaches to stop hypertension diet and risk of stroke

Feng

Fan

et al. 2018

Medicine

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“…Meta-analyses of cohort studies revealed a linear and inverse association between DASH diet intake and the risks of coronary artery disease, stroke and heart failure (18,19) . Recent analyses confirm the cardioprotective effects of high adherence to the DASH diet that was associated with the lower risk of specific cardiovascular events (coronary artery disease and stroke), total incident cardiovascular events and also CVD-related death (20,21) .…”

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confidence: 89%

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

et al. 2020

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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.

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DASH Score and Subsequent Risk of Coronary Artery Disease: The Findings From Million Veteran Program

Cited by 33 publications

References 35 publications

Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Adherence to the dietary approaches to stop hypertension diet and risk of stroke

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

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