title: Effect of dietary patterns on ambulatory blood pressure : results from the Dietary Approaches to Stop Hypertension (DASH) Trial. DASH Collaborative Research Group.
abstract: We measured ambulatory blood pressure (ABP) in 354 participants in the Dietary Approaches to Stop Hypertension (DASH) Trial to determine the effect of dietary treatment on ABP (24-hour, day and night) and to assess participants' acceptance of and compliance with the ABP monitoring (ABPM) technique. After a 3-week run-in period on a control "typical" American diet, subjects (diastolic blood pressure [BP], 80 to 95 mm Hg; systolic BP, <160 mm Hg; mean age, 45 years) were randomly assigned to 1 of 3 diets for an 8-week intervention period: a continuation of the control diet; a diet rich in fruits and vegetables; and a "combination" diet that emphasized fruits, vegetables, and low-fat dairy products. We measured ABP at the end of the run-in and intervention periods. Both the fruit/vegetable and combination diets lowered 24-hour ABP significantly compared with the control diet (P<0. 0001 for systolic and diastolic pressures on both diets: control diet, -0.2/+0.1 mm Hg; fruit/vegetable diet, -3.2/-1.9 mm Hg; combination diet, -4.6/-2. 6 mm Hg). The combination diet lowered pressure during both day and night. Hypertensive subjects had a significantly greater response than normotensives to the combination diet (24-hour ABP, -10.1/-5.5 versus -2.3/-1.6 mm Hg, respectively). After correction for the control diet responses, the magnitude of BP lowering was not significantly different whether measured by ABPM or random-zero sphygmomanometry. Participant acceptance of ABPM was excellent: only 1 participant refused to wear the ABP monitor, and 7 subjects (2%) provided incomplete recordings. These results demonstrate that the DASH combination diet provides significant round-the-clock reduction in BP, especially in hypertensive participants.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Mass., USA. thomas_moore@merck.com
authors.forename: T J
authors.initials: TJ
authors.lastname: Moore
authors.forename: W M
authors.initials: WM
authors.lastname: Vollmer
authors.forename: L J
authors.initials: LJ
authors.lastname: Appel
authors.forename: F M
authors.initials: FM
authors.lastname: Sacks
authors.forename: L P
authors.initials: LP
authors.lastname: Svetkey
authors.forename: T M
authors.initials: TM
authors.lastname: Vogt
authors.forename: P R
authors.initials: PR
authors.lastname: Conlin
authors.forename: D G
authors.initials: DG
authors.lastname: Simons-Morton
authors.forename: L
authors.initials: L
authors.lastname: Carter-Edwards
authors.forename: D W
authors.initials: DW
authors.lastname: Harsha
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016896:Treatment Outcome