Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Hypertension is a major risk factor for developing cardiovascular disease, stroke, and kidney disease. To lower blood pressure (BP), several lifestyle changes are recommended such as weight loss, exercise, and following a healthy diet. Investigating the effect of single nutrients may have positive results, but food is consumed as part of a whole diet, resulting in nutrient interactions. The aim of this systematic review and meta-analysis was to assess the effect of dietary patterns on BP in adults. Studies that were published between January 1999 and June 2014 were retrieved using Scopus, Web of Science, and the MEDLINE database. Seventeen randomized controlled trials were included in the meta-analysis. The results suggest that healthy dietary patterns such as the Dietary Approaches to Stop Hypertension diet, Nordic diet, and Mediterranean diet significantly lowered systolic BP and diastolic BP by 4.26 mm Hg and 2.38 mm Hg, respectively. These diets are rich in fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy and low in meat, sweets, and alcohol. Lifestyle factors such as exercise and weight loss in combination with dietary changes may also reduce BP. Further research is needed to establish the effect of dietary patterns on BP in different cultures other than those identified in this review. The review was registered on PROSPERO (International prospective register of systematic reviews) as CRD42015016272.

Association between dietary patterns and cardiovascular risk factors in a selected population of Lower Silesia (PURE Study Poland)

“…Surprisingly, greater adherence to the 'fat & sugar' DP was associated with lower systolic blood pressure. These results were not consistent with the current knowledge on this topic [39]. However, subjects in Q4 of the 'fat & sugar' DP, despite similar BMI and waist circumference and lower sodium intake, were younger (P=0.0006) and had higher physical activity level (P < 0.0001) than subjects in Q1, which may partially explain the observed relationships.…”

Associations between Dietary Patterns and Blood Pressure in a Clinical Sample of Overweight Adults

“…Dietary patterns such as the DASH diet [19], the Mediterranean diet [21] and the Nordic diet [41] have been shown to reduce BP. In our previous research, a meta-analysis of 17 randomized controlled trials showed that a dietary pattern that was rich in fruits, vegetables, wholegrains, legumes, nuts, seeds, dairy and fish and low in processed foods and red meat reduced SBP and DBP by 4.06 mmHg and 2.30 mmHg, respectively [42]. In the current study, a diet that was high in nuts, seeds, fruit and fish was associated with lower BP and therefore our findings are consistent with previous research.…”

Dietary patterns associated with hypertension risk among adults in Thailand: 8-year findings from the Thai Cohort Study

“…Analysing the association between overall dietary pattern and health outcomes is becoming more common as it may account for cumulative and interactive effects and control for dietary confounding (11) . However, the association between overall dietary patterns and hypertension has not been thoroughly studied and the findings are inconclusive (2,10,(12)(13)(14) . Diet is largely determined by regional food availability, culture and distribution.…”

“…As well, low intakes of vegetable protein (3) , Mg (4) , P (5) and PUFA (6) , and higher intakes of soft drinks (7) , cholesterol (8) , animal protein (3) and red meat (9) , have also been shown to be related to hypertension. Accumulating evidence from randomized clinical trials has shown that vegetarian diets, and those low in saturated animal fat and high in dietary fibre such as the Dietary Approaches to Stop Hypertension (DASH) diet, can effectively lower blood pressure (2,10) . Analysing the association between overall dietary pattern and health outcomes is becoming more common as it may account for cumulative and interactive effects and control for dietary confounding (11) .…”