title: Blood pressure differences associated with Optimal Macronutrient Intake Trial for Heart Health (OMNIHEART)-like diet compared with a typical American Diet.
abstract: The Dietary Approaches to Stop Hypertension-Sodium (DASH-Sodium) trial demonstrated beneficial effects on blood pressure (BP) of the DASH diet with lower sodium intake when compared with typical American diet. The subsequent Optimal Macronutrient Intake Trial for Heart Health (OMNIHEART) trial reported additional BP benefits from replacing carbohydrate in the DASH diet with either protein or monounsaturated fats. The primary aim of this study is to assess possible BP benefits of an OMNIHEART-like diet in free-living Americans using cross-sectional US population data of the International Study of Macronutrients, Micronutrients and Blood Pressure (INTERMAP) study. The INTERMAP data include four 24-hour dietary recalls, 2 timed 24-hour urine collections, 8 BP readings for 2195 individuals aged 40 to 59 years from 8 US INTERMAP population samples. Analyses are conducted using 2 approaches: (1) regression of BP on a linear OMNIHEART nutrient score calculated for each individual and (2) a Bayesian approach comparing estimated BP levels of an OMNIHEART-like nutrient profile with a typical American nutrient profile. After adjustment for potential confounders, an OMNIHEART score higher by 1 point was associated with systolic/diastolic BP differences of -1.0/-0.5 mm Hg (both P<0.001). Mean systolic/diastolic BPs were 111.3/68.4 and 115.2/70.6 mm Hg for Bayesian OMNIHEART and Control profiles, respectively, after controlling for possible confounders, with BP differences of -3.9/-2.2 mm Hg, P(difference≤0)=0.98/0.96. Findings were comparable for men and women, for nonhypertensive participants, and with adjustment for antihypertensive treatment. Our findings from data on US population samples indicate broad generalizability of OMNIHEART results beyond the trial setting and support recommendations for an OMNIHEART-style diet for prevention/control of population-wide adverse BP levels.
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.). p.elliott@imperial.ac.uk john.molitor@oregonstate.edu.
authors.forename: John
authors.initials: J
authors.lastname: Molitor
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Brown
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Michail
authors.initials: M
authors.lastname: Papathomas
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Silvia
authors.initials: S
authors.lastname: Liverani
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: NuooTing
authors.initials: N
authors.lastname: Molitor
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Sylvia
authors.initials: S
authors.lastname: Richardson
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Alan
authors.initials: A
authors.lastname: Dyer
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Stamler
authors.affiliation: From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.). p.elliott@imperial.ac.uk john.molitor@oregonstate.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D004041:Dietary Fats / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D005247:Feeding Behavior; D005260:Female; D014943:Global Health; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012982:Sodium, Dietary / Q000008:administration & dosage*
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins; D012982:Sodium, Dietary
keywords: blood pressure; hypertension; nutrients; statistics