The effects of dietary patterns on plasma renin activity: results from the Dietary Approaches to Stop Hypertension trial

Abstract

A diet rich in fruits, vegetables and low-fat dairy products, and reduced in saturated fat, total fat and cholesterol (the 'DASH' diet) significantly lowers blood pressure (BP). Previous studies have documented that certain therapies that lower BP increase plasma renin activity (PRA). Using data from the Dietary Approaches to Stop Hypertension (DASH) trial, we assessed the effects of dietary patterns on PRA and determined the relationship of change in PRA with change in BP on each diet. After eating a control diet for 3 weeks, participants were then randomized to receive for 8 weeks: the control diet, a diet rich in fruits and vegetables (F/V), or the DASH diet. Baseline and follow-up levels of PRA were available in 381 participants. Compared with the control diet, the DASH diet increased PRA by 0.37 ng ml À1 h À1 (P ¼ 0.01). In multivariable linear regression analyses, there was an inverse association of PRA change with systolic BP change on the control diet (slope ¼ À0.35, P ¼ 0.001), but PRA did not differ by BP change on the F/V diet (slope ¼ À0.002, P ¼ 0.98) or DASH diet (slope ¼ À0.08, P ¼ 0.32). These data suggest that a blunted counter-regulatory response of the reninangiotensin system is associated with the BP-lowering effect of the F/V and DASH diets.

A randomised controlled trial evaluating the effect of potassium supplementation on vascular function and the renin–angiotensin–aldosterone system

“…28 In this study, a separate diet with a high fruit and vegetable intake also significantly increased urinary potassium but did not significantly change plasma renin activity. Both diets lowered blood pressure.…”

The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta‐analysis of randomized controlled clinical trials

“…After reading full text of eligible articles, 61 studies were excluded because ten studies compared combination of DASH diet along with other lifestyle modifications such as exercise program, and therefore, the independent effects of DASH diet could not be assessed ; two were conducted in pregnant women ; seven publications compared the effect of different types of the DASH diet ; six studies were cross‐over in design , and the duration of one study was less than 8 weeks . In a study that was named as DASH trial, it was mentioned by authors that weight was actively maintained by changing the energy intake during the study period ; therefore, we excluded this study and 14 publications that used its data . Sixteen studies were also excluded because they were conducted on the data from bigger studies [Exercise and Nutrition Interventions for Cardiovascular Health , sodium DASH trial and PREMIER ].…”

The role of nutrition and nutraceutical supplements in the treatment of hypertension

“…These reductions persisted as long as the patients were on the diet. The DASH diet increases plasma renin activity (PRA) and serum aldosterone levels in response to the BP reductions [46,47] . The mean increase in PRA was 37 ng/mL per day [47] .…”

“…The DASH diet increases plasma renin activity (PRA) and serum aldosterone levels in response to the BP reductions [46,47] . The mean increase in PRA was 37 ng/mL per day [47] . There was an associated of response with the G46A polymorphism of beta 2 adrenergic receptor.…”