A combination of the DASH diet and restricting sodium intake may achieve significant reductions in blood pressure (BP) in adults with pre-hypertension, stage I hypertension and baseline systolic BP (SBP) of >150 mmHg, according to results of the DASH-Sodium trial presented Nov. 12 at AHA 2017 in Anaheim, CA, and simultaneously published in the Journal of the American College of Cardiology.

Stephen P. Juraschek, MD, PhD, et al., randomized 412 participants to either the DASH diet or a control diet. Of the participants, 57 percent were women, 57 percent were black, the mean age was 48 years, and the mean SBP/diastolic BP (DBP) was 135/86 mmHg. All participants, regardless of diet, were given food containing three different levels of sodium (50, 100, and 150 mmol/day at 2,100 kcal) in random order over four weeks separated by five-day breaks. Strata of baseline SBP were<130, 130-139, 140-149, and ≥150 mmHg.

Results showed that reducing sodium (from high to low) was associated with mean SBP differences of -3.20, -8.56, -8.99, and -7.04 mmHg, respectively, across the baseline SBP strata for participants in the control diet group, while the DASH diet was associated with mean SBP differences of -4.5, -4.3, -4.7, and -10.6 mmHg, respectively. The combined effects of the low sodium-DASH diet vs. the high sodium-control diet on SBP were -5.3, -7.5, -9.7, and -20.8 mmHg, respectively.

"These findings demonstrate that the individual and combined effects from both sodium reduction and the DASH diet are profound particularly in hypertensive persons with higher BP," researchers said. They also noted that SBP reductions in adults with the highest levels of SBP (≥150 mmHg) "were striking and reinforce the importance of both sodium reduction and the DASH diet in this high-risk group."

The study did have limitations, for example, adults with chronic kidney disease, medication-treated hypertension, medication-treated diabetes, and heart failure were excluded from participation. Additionally, adults with a SBP >160 mmHg, or stage 2 hypertension, were also excluded. "Future studies should determine the magnitude of BP reduction that can be achieved in patients with more severe hypertension and in those with heart failure and kidney disease," they said.

Keywords: AHA17, Blood Pressure, Prehypertension, Sodium, Research Personnel, Diet, Sodium-Restricted, Hypertension, Sodium, Dietary, Diastole, Diabetes Mellitus, Renal Insufficiency, Chronic, Heart Failure, AHA Annual Scientific Sessions

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