Dietary Intervention no Different from Antihypertensive Drugs in Controlling Blood Pressure
등록일 2019년 01월 07일 토요일
수정일 2017년 11월 25일 토요일

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A study, conducted by researchers at the Johns Hopkins University School of Medicine and published in the Journal of the American College of Cardiology, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowered the systolic blood pressure of people with baseline systolic readings.The result of the randomized clinical trial of the dietary combination was conducted on more than 400 adults with stage 1 high blood pressure or prehypertension.

Stephen Juraschek, MD, an adjunct assistant professor at Johns Hopkins and an instructor of medicine at Harvard Medical School, said that their results added to the evidence that dietary interventions are as effective as the antihypertensive drugs in those at the highest risk for blood pressure.He said that the nutritional invention should be the routine for first-line treatment of individuals with the conditions.

About DASH

The Dietary Approaches to Stop Hypertension diet which was long promoted by the National Heart, Lung, and Blood Institute and the American Heart Association should be rich in whole grains, fruits, vegetables, fish, poultry, beans, seeds, nuts and low in fat or fat-free dairy food.It was developed by the US National Institutes of health to lower medication without medication.

The first research showed that DASH could lower blood pressure even with an intake of 3300 mg/day of sodium.Since then studies have shown that DASH food can control diseases such as stroke, cancer, heart disease, kidney stones, and diabetes.

The improved diet and the Plan

The original ones didn't cater to weight loss and were rather high on carb and starchy foods.Since weight loss was important to many, there was pressure to create an easy-to-follow plan on weight loss based on the DASH diet food.The DASH diet eating plan consists of vegetables, fruits, non-fat dairy, and fruits.It is high in fiber, moderately low in fat, and it strictly follows the US guidelines for sodium content.

While both DASH diets and low-sodium have been known to prevent and lower blood pressure, Juraschek said that the new study is designed to examine the effects of combining diets among adults with modest or early forms of high blood pressure.These adults are considered to be at risk of developing a more severe form of hypertension which is known to increase the likelihood of kidney disease, heart attacks, stroke, and heart failure.

How the research was conducted

For the research, investigators tested and followed 412 adults, including 234 women ranging between the age of 23-76 years and with a diastolic blood pressure of between 80-95 mm Hg and a systolic blood pressure of 120-159mm Hg.Around 57 percent of the participants were African-American.

At the start, no participants were taking insulin or antihypertensive drugs, nor did they have a prior diagnosis of renal insufficiency, heart disease, diabetes or poorly controlled cholesterol.The researchers put all the partakers on a control diet and the DASH diet for 12 weeks.The control one was similar to that of the typical American food with the average micronutrient and macronutrients profile of the US population.

All the participants were also given 50 (low), 100 (medium), 150(high) mmol/day of sodium in a random order over a four week period.  A diet that included a 100 mmol/day is equivalent to 2300 mg of sodium and is nearly a teaspoon of salt.According to the National Health and Nutrition Examination Survey, the people taking the test consumed about 150 mmol/day of sodium which is considered harmful by FDA and increases the person's risk of getting high blood pressure, stroke, and heart disease.

The participants were grouped into four based on their baseline systolic blood pressure -- 120-129, 130-139, 140-149, and 150 or greater baseline systolic blood pressure.After four weeks of study, the researchers found out that the group with 150 and greater baseline systolic on just the DASH diet had an average of 11mm Hg reduction.

When the investigators combined the DASH diet with a low-sodium diet and compared the blood pressure with those on a high-sodium controlled diet, they noted that the group with less than 130 systolic blood pressure baselines had a 5 mm Hg reduction in systolic pressure.Those with 130-139 mm Hg baseline systolic blood pressure had 7 mm Hg reduction; the group with 140-149 had 10 m Hg reduction.

The most surprising revelation was that of the participants with a baseline systolic blood pressure greater than 150 consuming both the DASH diet and low-sodium diet had an average reduction of 21 mm Hg in systolic blood pressure compared to the high sodium controlled diet.

Juraschek said that the research was outstanding as those at higher risk benefited more from the mixed diet.Senior study author Lawrence Appel noted that what they were observing was a reduction of the systolic blood pressure as high if not more significant than that which can be achieved with prescription drugs.

However, these researchers cautioned that the study didn't address the effect of the combination to people with 160 or greater and further studies would be appropriate to investigate on this population.

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