The dietary approaches to stop hypertension (DASH) clinical trial: implications for lifestyle modifications in the treatment of hypertensive patients.

Lifestyle modifications, such as weight loss, sodium restriction, and limiting alcohol consumption, are important components of the initial treatment of hypertensive patients. The Dietary Approaches to Stop Hypertension (DASH) study investigated the effects of dietary patterns on blood pressure in individuals with diastolic blood pressure between 80-95 mmHg. Two different dietary patterns were tested in this feeding study. A diet enriched in fruits and vegetables and a diet enriched in fruits, vegetables, and low-fat dairy products and low in total and saturated fat (combination diet) were compared with a control diet. Dietary intake was adjusted so that participants did not lose weight, and all study diets had comparable sodium intake (approximately 3 grams/day). All meals were provided for 459 participants for an 11-week period. Those randomized to the combination diet (n = 151) had a significant change in systolic (-5.5 mmHg; p < 0.001) and diastolic blood pressure (-3.0 mmHg; p < 0.001) after subtracting the response to the control diet (n = 154). The fruits-and-vegetables diet (n = 154) produced a significant but lesser decrease in blood pressure (systolic, -2.8 mmHg; p < 0.001 and diastolic, -1.1 mmHg; p = 0.07). Hypertensive individuals and African Americans had particularly favorable responses with blood pressure reductions, which were significantly greater than other subgroups. The combination diet was well-accepted and adherence to the diet was high (>90%) for all participants. The DASH combination diet is an effective lifestyle modification for lowering blood pressure in patients with high-normal or Stage 1 hypertension.