MedicalResearch.com Interview with:
Stephen P. Juraschek, MD, PhD
Instructor of Medicine
Beth Israel Deaconess Medical Center/Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The DASH-Sodium trial demonstrated that both the DASH diet and sodium restriction, individually and combined, lowered blood pressure in adults with pre-hypertension or stage 1 hypertension. Whether these effects varied by level of blood pressure prior to starting these interventions was unknown. In a secondary analysis of the original DASH diet it had been observed that the effects from DASH were greater among adults with higher blood pressure (systolic greater than or equal to 140 mm Hg) at baseline with the appearance of even greater effects among people with baseline systolic blood pressures above 150 mm Hg. However, this has never been shown. Furthermore, it was unknown whether sodium reduction followed a similar linear trend of greater effects among adults with more severely uncontrolled systolic blood pressure.
In our study, we found that effects were indeed greater in adults with a baseline systolic blood pressure of 150 mm Hg or greater. Furthermore, the combined systolic blood pressure-lowering effect from both interventions was as high was 20 mm Hg. This is a magnitude comparable if not greater than medications for lowering blood pressure.
MedicalResearch.com: What should readers take away from your report?
Response: Diet has profound effects on blood pressure. Placing this effect in context, the FDA recommends that new anti-hypertensive drugs lower systolic blood pressure by at least 3-4 mm Hg. Similarly, known classes of antihypertensive agents (i.e. angiotensin converting enzyme inhibitors, beta blockers, and calcium channel blockers) lower systolic blood pressure by 10-16 mm Hg on average. Diet alone, especially the DASH diet and a low sodium diet, can achieve even greater effects in adults with uncontrolled hypertension.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Additional studies of diet for blood pressure reduction are needed, particularly in adults with systolic blood pressures 160 mm Hg or greater as well as in adults with diabetes, kidney disease, or heart failure.
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