title: Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study.
abstract: BACKGROUND
  Although the DASH (Dietary Approaches to Stop Hypertension) diet has been shown to lower blood pressure (BP) in short-term feeding studies, it has not been shown to lower BP among free-living individuals, nor has it been shown to alter cardiovascular biomarkers of risk.
  
  
  OBJECTIVE
  To compare the DASH diet alone or combined with a weight management program with usual diet controls among participants with prehypertension or stage 1 hypertension (systolic BP, 130-159 mm Hg; or diastolic BP, 85-99 mm Hg).
  
  
  METHODS
  Randomized, controlled trial in a tertiary care medical center with assessments at baseline and 4 months. Enrollment began October 29, 2003, and ended July 28, 2008.
  
  
  METHODS
  Overweight or obese, unmedicated outpatients with high BP (N = 144).
  
  
  METHODS
  Usual diet controls, DASH diet alone, and DASH diet plus weight management.
  
  
  METHODS
  The main outcome measure is BP measured in the clinic and by ambulatory BP monitoring. Secondary outcomes included pulse wave velocity, flow-mediated dilation of the brachial artery, baroreflex sensitivity, and left ventricular mass.
  
  
  RESULTS
  Clinic-measured BP was reduced by 16.1/9.9 mm Hg (DASH plus weight management); 11.2/7.5 mm (DASH alone); and 3.4/3.8 mm (usual diet controls) (P < .001). A similar pattern was observed for ambulatory BP (P < .05). Greater improvement was noted for DASH plus weight management compared with DASH alone for pulse wave velocity, baroreflex sensitivity, and left ventricular mass (all P < .05).
  
  
  CONCLUSIONS
  For overweight or obese persons with above-normal BP, the addition of exercise and weight loss to the DASH diet resulted in even larger BP reductions, greater improvements in vascular and autonomic function, and reduced left ventricular mass.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00571844.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Campus Box 3119, Durham, NC 27710, USA. Blume003@mc.duke.edu
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
authors.forename: Michael A
authors.initials: MA
authors.lastname: Babyak
authors.forename: Alan
authors.initials: A
authors.lastname: Hinderliter
authors.forename: Lana L
authors.initials: LL
authors.lastname: Watkins
authors.forename: Linda
authors.initials: L
authors.lastname: Craighead
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.forename: Carla
authors.initials: C
authors.lastname: Caccia
authors.forename: Julie
authors.initials: J
authors.lastname: Johnson
authors.forename: Robert
authors.initials: R
authors.lastname: Waugh
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
mesh_terms: D001794:Blood Pressure; D003376:Counseling; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy; D050177:Overweight / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy; D011188:Potassium / Q000652:urine; D012964:Sodium / Q000652:urine; D015431:Weight Loss
chemical_list: D012964:Sodium; D011188:Potassium