Hypertension is high blood pressure, which is the force at which blood is coursing through the blood vessels. High blood pressure is linked to numerous diseases, including heart disease, stroke and kidney disease. Treatment involves lifestyle modifications such as appropriate diet and exercise as well as medical therapy. The DASH diet is one method of dietary management. Diet, exercise, diagnosis and treatments should be undertaken with the consultation of a health care professional.
DASH Trial
The DASH trial was a medical study by Johns Hopkins University, supported by the National Heart, Lung and Blood Institute and published in the "New England Journal of Medicine" in 1997. In this trial, groups of people ate one of three diets. One was a diet that was low in fruits and vegetables, another was high in fruits and vegetables, and the third was the DASH diet, which stands for Dietary Approaches to Stop Hypertension. It was high in fruits, vegetables and low-fat dairy products, and low in total and saturated fat, red meat and sugars. It also included fish, poultry, nuts and whole grain products. The DASH trial found that on average the DASH diet reduced the blood pressure by 11.4 / 5.5 mm Hg in people with high blood pressure, compared to 2.8 / 1.1 in the fruits and vegetables diet.
Low Sodium DASH Trial
The low sodium DASH trial, done through the Brigham and Women's Hospital and Harvard Medical School, was similar to the DASH trial, except it also controlled for different levels of sodium. It was found that lower sodium caused even further decreases in blood pressure. This was most pronounced for those who already had high blood pressure, African-Americans and middle aged to elderly individuals.
DASH Daily Nutrient Goals
The U.S. Department of Health and Human Services Guide to Lowering Your Blood Pressure with DASH lists the daily nutrient goals of the diet. Total fat should come from no more than 27 percent of the calories, saturated fat 6 percent of the calories and cholesterol 150 mg. Protein should supply about 18 percent of the calories and carbohydrates 55 percent of the calories. The diet also requires 30 grams of fiber. Additionally it calls for 4,700 mg of potassium, 1,250 mg of calcium and 500 mg of calcium. The regular DASH diet calls for 2,300 mg of sodium and the reduced sodium diet allows for 1,500 mg of sodium.
PREMIER Trial
The PREMIER trial, published in the "Journal of the American Medical Association" in 2003, also tested three groups. One group made behavioral changes such as limited sodium and alcohol intake, exercise and weight loss and was given continued support in these efforts. Another group followed the DASH diet plus the behavioral changes, and the third group, the comparison group, was given one time advice to limit sodium, alcohol and lose weight. The behavioral modifications plus the DASH diet resulted in an additional small decrease in blood pressure.
References
- "New England Journal of Medicine"; "A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group."; Appel et al; 1997
- "New England Journal of Medicine"; "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group."; Sacks et al; 2001
- NIH: U.S. Deparment of Health and Human Services: Your Guide to Lowering Your Blood Pressure with DASH
- "Journal of the American Medical Association"; "Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial."; Appel et al; 2003
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