A structured grocery home-delivery program aligned with the DASH (Dietary Approaches to Stop Hypertension) diet along with dietitian counseling significantly reduced systolic blood pressure (SBP) and LDL-C among Black adults with hypertension living in a food desert compared with a grocery stipend and basic dietary guidance, according to results from the GoFreshRx trial, presented during a Late-Breaking Clinical Trial session at ACC.26 in New Orleans and simultaneously published in Nature Medicine.

Stephen Paul Juraschek, MD, PhD, et al., randomized 176 Black participants with treated hypertension with an SBP between 120-149 mm Hg who lived in Boston communities with few grocery stores and low incomes 1:1 to either home-delivered groceries with personalized guidance from a dietitian in DASH food selection or a monthly grocery stipend and a pamphlet explaining the DASH diet, which is high in fruits, vegetables, whole grains, low-fat dairy, nuts, seeds, legumes and other lean proteins.

Participants were 60 years old on average and 80% were women. Baseline SBP and diastolic BP (DBP) was 131/78 mm Hg.

Results at three months revealed an average overall 7 mm Hg reduction in SBP in the grocery delivery group and 2 mm Hg in the grocery stipend group (p=0.002).

The home-delivery group also had a greater reduction than the grocery stipend group in the secondary endpoints of DBP (1.8 mm Hg difference) and LDL-C (by 7 mg/dL vs. 1.8 mg/dL). The reductions in the primary and secondary outcomes persisted three months after the intervention ended.

The authors note that the study was limited to one metropolitan area and lasted only three months. Although the grocery home-delivery program worked well in the Boston area, it might not be feasible in more rural areas. Further studies could examine longer-term outcomes, additional endpoints for a more detailed picture of cardiovascular health, and outcomes in other high-risk populations such as patients with diabetes or those with SBP >150 mm Hg.

“We’re very excited by the magnitude of the effects – it’s really above and beyond what we anticipated,” said Juraschek. “This study shows a real path forward for self-management among individuals with hypertension.”

Clinical Topics: Prevention, Diet, Hypertension

Keywords: ACC Annual Scientific Session, ACC26, New Orleans, Diet, Hypertension, Primary Prevention