Subjects Following DASH Diet Associated with Reduced Risk of Hypertension

by | Sep 25, 2023 | 2023, Blood Pressure, Cardiovascular Health, Nutrition and Dieting

Written by Taylor Woosley, Staff Writer. South Asian immigrant participants in the highest DASH score category had a 67% less chance of developing hypertension compared to subjects in the lowest DASH score category. 

blood pressure cuffCardiovascular disease is the leading contributor to global mortality and encompasses multiple disorders, including atherosclerosis, hypertension, stroke, and heart failure1. Hypertension is accompanied by a systemic inflammatory response that promotes renal and vascular dysfunction, worsening blood pressure elevation, and can lead to end organ damage2. In 2000, the worldwide number of adult patients with hypertension was reported to be 972 million, while the number is estimated to reach 1.56 billion by 20253.

The majority of cardiovascular diseases, such as hypertension, are largely influenced by modifiable lifestyle and nutrition factors4. Consistent evidence suggests that individual nutrients, such as sodium and potassium, but also different dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet, are directly associated with blood pressure reduction5. These benefits may arise from the emphasis on consumption of fruits, vegetables, whole grains, legumes, nuts, lean protein, and low-fat dairy products, with limited intake of salt, added sugar, and saturated fat6.

Hussain et al. conducted a study using data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) to analyze prospective associations of the DASH dietary patterns with measures of blood pressure and hypertension. MASALA is a community-based prospective cohort study of South Asian immigrants aged 40-84 years living in the United States. Subjects included in the study had no diagnosed cardiovascular disease at enrollment and were living in either the San Francisco or Chicago metropolitan areas. Participants (n = 746) from Exam 1 (baseline, 2010-2013) and Exam 2 (2015-2018) were included in the final analysis.

Dietary food intake was collected via the Study of Health Assessment and Risk in Ethnic (SHARE) food frequency questionnaire (FFQ) to assess average daily quantity and serving sizes of food consumed. The SHARE FFQ data was then used to compute DASH dietary concordance scores. Sociodemographic data including amount of time lived in the U.S., education levels, and family income was collected during Exam 1. Further information on smoking and alcohol consumption status and physical activity levels were also included in the final analysis. Clinical data including coronary artery calcium scores (CAC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and fasting glucose. Blood pressure was calculated based on the average of two readings.

Pearson’s chi-square for categorical variables was utilized to evaluate between-group differences. Tests of linear trends across groups was analyzed using analysis of variance (ANOVA) for continuous variables. Multinominal logistic regression was used to estimate relative risk ratios for the association between DASH diet scores and incident of hypertension at Exam 2. Significant findings of the study are as follows:

  • There was a larger proportion of subjects with no hypertension in the highest DASH diet score category, and those with incident hypertension at Exam 2 were in the lowest DASH diet score category (p = 0.01).
  • The relative risk ratio of incident hypertension versus no hypertension at Exam 2 was 67% lower in subjects in the highest DASH diet score category (ptrend = 0.02) compared with those in the low DASH diet score category.
  • Incident hypertension was 77% lower among men in the highest DASH diet score category (ptrend = 0.03) compared with men in the low DASH diet score category.

Results of the study using data from MASALA shows that strict adherence to the DASH diet was associated with a reduced risk of developing hypertension after a 5-year follow-up. Findings show the importance of diet-related interventions to reduce blood pressure. Study limitations include the use of an FFQ to calculate DASH diet scores which has the potential for subject recall bias and the small sample size of participants.

Source: Hussain, Bridget Murphy, Andrea L. Deierlein, Alka M. Kanaya, Sameera A. Talegawkar, Joyce A. O’Connor, Meghana D. Gadgil, Yong Lin, and Niyati Parekh. “Concordance between Dash Diet and Hypertension: Results from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study.” Nutrients 15, no. 16 (2023): 3611.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Posted September 25, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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