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. The dietary approaches to stop hypertension (DASH) clinical trial: implications for lifestyle modifications in the treatment of hypertensive patients. Determinants and consequences of adherence to the dietary approaches to stop hypertension diet in African-American and white adults with high blood pressure: results from the ENCORE trial. Dietary Approaches to Stop Hypertension (DASH) diet: applicability and acceptability to a UK population. DASH (Dietary Approaches to Stop Hypertension) Diet Is Effective Treatment for Stage 1 Isolated Systolic Hypertension Effects of the Dietary Approaches to Stop Hypertension (DASH) Eating Plan on Cardiovascular Risks Among Type 2 Diabetic Patients Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial. The DASH diet and diet costs among ethnic and racial groups in the United States. Does the DASH diet lower blood pressure by altering peripheral vascular function? Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on the Pressure-Natriuresis Relationship Low-sodium Dietary Approaches to Stop Hypertension-type diet including lean red meat lowers blood pressure in postmenopausal women. Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. DASH Diet Lowers Blood Pressure and Lipid-Induced Oxidative Stress in Obesity Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. Effects of the Dietary Approaches to Stop Hypertension Diet, Exercise, and Caloric Restriction on Neurocognition in Overweight Adults With High Blood Pressure
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 ) . DESIGN AND SETTING R and omized , controlled trial in a tertiary care medical center with assessment s at baseline and 4 months . Enrollment began October 29 , 2003 , and ended July 28 , 2008 . PARTICIPANTS Overweight or obese , unmedicated out patients with high BP ( N = 144 ) . INTERVENTIONS Usual diet controls , DASH diet alone , and DASH diet plus weight management . OUTCOME MEASURES 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 ) . CONCLUSION For overweight or obese persons with above-normal BP , the addition of exercise and weight loss to the DASH diet result ed in even larger BP reductions , greater improvements in vascular and autonomic function , and reduced left ventricular mass . CLINICAL TRIAL REGISTRATION clinical trials.gov Identifier : NCT00571844 Lifestyle modifications , such as weight loss , sodium restriction , and limiting alcohol consumption , are important components of the initial treatment of hypertensive patients . The Dietary Approaches to Stop Hypertension ( DASH ) study investigated the effects of dietary patterns on blood pressure in individuals with diastolic blood pressure between 80 - 95 mmHg . Two different dietary patterns were tested in this feeding study . A diet enriched in fruits and vegetables and a diet enriched in fruits , vegetables , and low-fat dairy products and low in total and saturated fat ( combination diet ) were compared with a control diet . Dietary intake was adjusted so that participants did not lose weight , and all study diets had comparable sodium intake ( approximately 3 grams/day ) . All meals were provided for 459 participants for an 11-week period . Those r and omized to the combination diet ( n = 151 ) had a significant change in systolic ( -5.5 mmHg ; p < 0.001 ) and diastolic blood pressure ( -3.0 mmHg ; p < 0.001 ) after subtracting the response to the control diet ( n = 154 ) . The fruits- and -vegetables diet ( n = 154 ) produced a significant but lesser decrease in blood pressure ( systolic , -2.8 mmHg ; p < 0.001 and diastolic , -1.1 mmHg ; p = 0.07 ) . Hypertensive individuals and African Americans had particularly favorable responses with blood pressure reductions , which were significantly greater than other subgroups . The combination diet was well-accepted and adherence to the diet was high ( > 90 % ) for all participants . The DASH combination diet is an effective lifestyle modification for lowering blood pressure in patients with high-normal or Stage 1 hypertension BACKGROUND Although the Dietary Approaches to Stop Hypertension ( DASH ) diet is an accepted nonpharmacologic treatment for hypertension , little is known about what patient characteristics affect dietary adherence and what level of adherence is needed to reduce blood pressure ( BP ) . OBJECTIVE Our aim was to determine what factors predict dietary adherence and the extent to which dietary adherence is necessary to produce clinical ly meaningful BP reductions . DESIGN Ancillary study of the ENCORE ( Exercise and Nutrition Interventions for Cardiovascular Health ) trial -- a 16-week r and omized clinical trial of diet and exercise . PARTICIPANTS / SETTING Participants included 144 sedentary , overweight , or obese adults ( body mass index 25 to 39.9 ) with high BP ( systolic 130 to 159 mm Hg and /or diastolic 85 to 99 mm Hg ) . INTERVENTION Patients were r and omized to one of three groups : DASH diet alone , DASH diet plus weight management , and Usual Diet Controls . MAIN OUTCOMES MEASURES Our primary outcomes were a composite index of adherence to the DASH diet and clinic BP . STATISTICAL ANALYSES PERFORMED General linear models were used to compare treatment groups on post-treatment adherence to the DASH diet . Linear regression was used to examine potential predictors of post-treatment DASH adherence . Analysis of covariance was used to examine the relation of adherence to the DASH diet and BP . RESULTS Participants in the DASH diet plus weight management ( 16.1 systolic BP [ SBP ] ; 95 % CI 13.0 to 19.2 mm Hg and 9.9 diastolic BP [ DBP ] ; 95 % CI 8.1 to 11.6 mm Hg ) and DASH diet alone ( 11.2 SBP ; 95 % CI 8.1 to 14.3 mm Hg and 7.5 DBP ; 95 % CI 5.8 to 9.3 mm Hg ) groups showed significant reductions in BP in comparison with Usual Diet Controls participants ( 3.4 SBP ; 95 % CI 0.4 to 6.4 mm Hg and DBP 3.8 ; 95 % CI 2.2 to 5.5 mm Hg ) . Greater post-treatment consumption of DASH foods was noted in both the DASH diet alone ( mean = 6.20 ; 95 % CI 5.83 to 6.57 ) and DASH diet plus weight management groups ( mean = 6.23 ; 95 % CI 5.88 to 6.59 ) compared with Usual Diet Controls ( mean = 3.66 ; 95 % CI 3.30 to 4.01 ; P<0.0001 ) , and greater adherence to the DASH diet was associated with larger reductions in clinic SBP and DBP ( P ≤ 0.01 ) . Only ethnicity predicted dietary adherence , with African Americans less adherent to the DASH diet compared with whites ( 4.68 ; 95 % CI 4.34 to 5.03 vs 5.83 ; 95 % CI 5.50 to 6.11 ; P<0.001 ) . CONCLUSIONS Greater adherence to the DASH diet was associated with larger BP reductions independent of weight loss . African Americans were less likely to be adherent to the DASH dietary eating plan compared with whites , suggesting that culturally sensitive dietary strategies might be needed to improve adherence to the DASH diet BACKGROUND The Dietary Approaches to Stop Hypertension ( DASH ) diet is widely promoted in the USA for the prevention and treatment of high blood pressure . It is high in fruit and vegetables , low-fat dairy and wholegrain foods and low in saturated fat and refined sugar . To our knowledge , the use of this dietary pattern has not been assessed in a free-living UK population . METHODS The DASH diet was adapted to fit UK food preferences and portion sizes . Fourteen healthy subjects followed the adapted DASH diet for 30 days in which they self-selected all food and beverages .  Dietary intake was assessed by 5-day food diaries completed before and towards the end of the study . Blood pressure was measured at the beginning and end of the study to assess compliance to the DASH style diet . RESULTS The DASH diet was easily adapted to fit with UK food preferences . Furthermore , it was well tolerated and accepted by subjects . When on the DASH style diet , subjects reported consuming significantly ( P < 0.01 ) more carbohydrate and protein and less total fat ( 5 % , 6 % and 9 % total energy , respectively ) . Sodium intakes decreased by 860 mg day(-1 ) ( P < 0.001 ) . Systolic and diastolic blood pressure decreased significantly ( P < 0.05 ) by 4.6 and 3.9 mmHg , respectively when on the DASH style diet . CONCLUSIONS The DASH style diet was well accepted and was associated with a decrease in blood pressure in normotensive individuals and should be considered when giving dietary advice to people with elevated blood pressure in the UK Use of the DASH ( Dietary Approaches to Stop Hypertension ) diet , which is rich in fruits , vegetables , and low-fat dairy foods , significantly lowers blood pressure .  Among the 459 participants in the DASH Trial , 72 had stage 1 isolated systolic hypertension ( ISH ) ( systolic blood pressure , 140 to 159 mm Hg ; diastolic blood pressure , < 90 mm Hg ) . We examined the blood pressure response in these 72 participants to determine whether the DASH diet is an effective treatment for stage 1 ISH . After a 3-week run-in period on a typical American ( control ) diet , participants were r and omly assigned for 8 weeks to 1 of 3 diets : a continuation of the control diet ( n=25 ) , a diet rich in fruits and vegetables ( n=24 ) , or the DASH diet ( n=23 ) . Sodium content was the same in the 3 diets , and caloric intake was adjusted during the trial to prevent weight change . Blood pressure was measured at baseline and at the end of the 8-week intervention period with st and ard sphygmomanometry . Use of the DASH diet significantly lowered systolic blood pressure compared with the control diet ( −11.2 mm Hg ; 95 % confidence interval , −6.1 to −16.2 mm Hg;P < 0.001 ) and the fruits/vegetables diet ( −8.0 mm Hg ; 95 % confidence interval , −2.5 to −13.4 mm Hg;P < 0.01 ) . Overall , blood pressure in the DASH group fell from 146/85 to 134/82 mm Hg . Similar results were observed with 24-hour ambulatory blood pressure measurements . In the DASH diet group , 18 of 23 participants ( 78 % ) reduced their systolic blood pressure to < 140 mm Hg , compared with 24 % and 50 % in the control and fruits/vegetables groups , respectively . Our results indicate that the DASH diet , which is rich in fruits , vegetables , and low-fat dairy foods , is effective as first-line therapy in stage 1 ISH OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks BACKGROUND The DASH ( Dietary Approaches to Stop Hypertension ) dietary pattern , which is high in fruit , vegetables , and low-fat dairy foods , significantly lowers blood pressure as well as low-density lipoprotein ( LDL ) and high-density lipoprotein ( HDL ) cholesterol . OBJECTIVE The study was design ed to test the effects of substituting full-fat for low-fat dairy foods in the DASH diet , with a corresponding increase in fat and a reduction in sugar intake , on blood pressure and plasma lipids and lipoproteins . DESIGN This was a 3-period r and omized crossover trial in free-living healthy individuals who consumed in r and om order a control diet , a st and ard DASH diet , and a higher-fat , lower-carbohydrate modification of the DASH diet ( HF-DASH diet ) for 3 wk each , separated by 2-wk washout periods . Laboratory measurements , which included lipoprotein particle concentrations determined by ion mobility , were made at the end of each experimental diet . RESULTS Thirty-six participants completed all 3 dietary periods . Blood pressure was reduced similarly with the DASH and HF-DASH diets compared with the control diet . The HF-DASH diet significantly reduced triglycerides and large and medium very-low-density lipoprotein ( VLDL ) particle concentrations and increased LDL peak particle diameter compared with the DASH diet . The DASH diet , but not the HF-DASH diet , significantly reduced LDL cholesterol , HDL cholesterol , apolipoprotein A-I , intermediate-density lipoprotein and large LDL particles , and LDL peak diameter compared with the control diet . CONCLUSIONS The HF-DASH diet lowered blood pressure to the same extent as the DASH diet but also reduced plasma triglyceride and VLDL concentrations without significantly increasing LDL cholesterol . This trial was registered at clinical trials.gov as NCT01404897 The Dietary Approaches to Stop Hypertension ( DASH ) diet is perhaps the best example of how a nutrient dense dietary pattern can prevent chronic disease . In r and omized trials , DASH dietary patterns lowered blood pressure  in hypertensive individuals.1 Subsequent trials and observational studies have consistently found that DASH-type diets reduced cardiovascular and metabolic We tested whether lowering of blood pressure ( BP ) on the dietary approaches to stop hypertension ( DASH ) diet was associated with changes in peripheral vascular function : endothelial function , assessed by flow-mediated vasodilatation ( FMD ) of the brachial artery , and subcutaneous adipose tissue blood flow ( ATBF ) . We also assessed effects on heart rate variability ( HRV ) as a measure of autonomic control of the heart . We allocated 27 men and women to DASH diet and control groups .  We measured FMD , ATBF and HRV on fasting and after ingestion of 75 g glucose , before and after 30 days on dietary intervention , aim ing for weight maintenance . The control group did not change their diet . The DASH-diet group complied with the diet as shown by significant reductions in systolic ( P<0.001 ) and diastolic ( P=0.005 ) BP , and in plasma C-reactive protein ( P<0.01 ) , LDL-cholesterol ( P<0.01 ) and apolipoprotein B ( P=0.001 ) , a novel finding . Body weight changed by < 1 kg . There were no changes in the control group . We found no changes in FMD , or in ATBF , in the DASH-diet group , although heart rate fell ( P<0.05 ) . Glucose and insulin concentrations did not change . In this small-scale study , the DASH diet lowered BP independently of peripheral mechanisms Epidemiologic studies have found that dietary patterns characterized by high intakes of certain minerals and fiber are associated with low blood pressure .  Dietary Approaches to Stop Hypertension ( DASH ) is a multicenter , r and omized , controlled-feeding trial design ed to test the effects on blood pressure of two such dietary patterns consumed for 8 weeks . The two experimental diets will be compared with each other and with a control dietary pattern that is relatively low in potassium , magnesium , calcium , and fiber , and has a fat and protein profile mirroring current consumption . The first experimental diet , arguably termed " ideal , " is high in fruits , vegetables , whole cereal products , low-fat dairy products , fish , chicken , and lean meats design ed to be low in saturated fat and cholesterol ; moderately high in protein ; and high in minerals and fiber . The second experimental diet tests the effect of fruits and vegetables alone . Its potassium , magnesium , and dietary fiber content will be at the same high levels as the ideal dietary pattern , while its fat , protein , and calcium content will resemble that of the control dietary pattern . The study population will consist of 456 healthy men and women , aged 22 years or older , with systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg . African-American and other minority groups will comprise 67 % of the population . Participants will eat one of the three dietary patterns . The DASH trial has unique features . First , dietary patterns rather than single nutrients are being tested . Second , all food for the experimental diets is provided to the participants using a st and ardized multicenter protocol . Because the dietary patterns are constructed with commonly consumed food items , the results , if positive , may be conveniently implemented in dietary recommendations to the general public Abstract —Blood pressure-lowering mechanisms of the Dietary Approaches to Stop Hypertension ( DASH ) diet , rich in fruits , vegetables , and low-fat dairy foods , were analyzed based on the pressure-natriuresis relationship . Participants ( n=375 ) were r and omly assigned to control or DASH diet groups by using a parallel-group design . They then ate their assigned diet for 3 consecutive 30-day intervention feeding periods , during which sodium intake varied among 3 levels by a r and omly assigned sequence . Urinary sodium excretion rate and mean arterial pressure were measured at the end of each sodium intake level . Mean arterial pressure and urinary sodium excretion were plotted on x and y axes , respectively , for participants eating control and DASH diets and were modeled as linear relationships for simplicity to allow the estimation of the extrapolated x-intercept and slope of the relationships . The DASH diet steepened the slope of the relationship ( 29.5±3.4 vs 64.9±13.1 [mmol/d]/mm Hg , P = 0.0002 ) without significantly shifting the x-intercept ( 94.1±0.5 vs 93.2±0.6 mm Hg , NS ) of the relationship . These data suggest a natriuretic action of the DASH diet Low-sodium Dietary Approaches to Stop Hypertension ( DASH ) diets are base producing but restrict red meat without clear justification . We hypothesized that a vitality diet ( VD ) , a low-sodium DASH-type diet with a low dietary acid load containing 6 servings of 100 g cooked lean red meat per week , would be more effective in reducing blood pressure ( BP ) compared with a higher acid load reference healthy diet ( RHD ) based on general dietary guidelines to reduce fat intake and increase intake of breads and cereals . A r and omized , parallel dietary intervention study was conducted to compare the BP-lowering effect of these 2 diets in postmenopausal women with high/normal BP . Women were r and omly assigned to follow either VD or RHD for 14 weeks . Home BP was measured daily with an automated BP monitor under st and ard conditions . Of 111 women commencing the study , 95 completed ( 46 VD , 49 RHD ) . Systolic BP ( SBP ) throughout the intervention was lower in the VD group compared to the RHD group ( repeated- measures analysis of variance time by diet , P = .04 ) , such that at the end of the study , the VD had a fall of SBP by 5.6 + /- 1.3 mm Hg ( mean + /- SEM ) compared with a fall of 2.7 + /- 1.0 mm Hg in the RHD ( group difference , P = .08 ) . When only those taking antihypertensive medications were assessed , the VD ( n = 17 ) had a significant fall of 6.5 + /- 2.5 mm Hg SBP ( P = .02 ) and 4.6 + /- 1.4 mm Hg diastolic BP ( P = .005 ) after 14 weeks , and their BP was lower than that of the RHD group ( n = 18 ) throughout the study ( P < .05 ) . We concluded that a low-sodium DASH diet with a low dietary acid load , which also included lean red meat on most days of the week , was effective in reducing  BP in older women , particularly in those taking antihypertensive medications OBJECTIVE To determine the effects of dietary patterns on blood pressure in subgroups . METHODS Dietary Approaches to Stop Hypertension ( DASH ) was a r and omized controlled feeding study conducted at 4 academic medical centers . Participants were 459 adults with untreated systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg . For 3 weeks , participants were fed a " control " diet . They were then r and omized to 8 weeks of ( 1 ) control diet ; ( 2 ) a diet rich in fruits and vegetables ; or ( 3 ) a combination diet rich in fruits , vegetables , and low-fat dairy foods , and reduced in saturated fat , total fat , and cholesterol ( the DASH combination diet ) . Weight and salt intake were held constant . Change in diastolic blood pressure was the primary outcome variable , and systolic blood pressure a secondary outcome . Subgroups analyzed included race , sex , age , body mass index , years of education , income , physical activity , alcohol intake , and hypertension status . RESULTS The combination diet significantly lowered systolic blood pressure in all subgroups ( P<.008 ) , and significantly lowered diastolic blood pressure ( P<.01 ) in all but 2 subgroups . The fruits- and -vegetables diet also reduced blood pressure in the same subgroups , but to a lesser extent . The combination diet lowered systolic blood pressure significantly more in African Americans ( 6.8 mm Hg ) than in whites ( 3.0 mm Hg ) , and in hypertensive subjects ( 11.4 mm Hg ) than in nonhypertensive subjects ( 3.4 mm Hg ) ( P<.05 for both interactions ) . CONCLUSIONS The DASH combination diet , without sodium reduction or weight loss , significantly lowered blood pressure in virtually all subgroups examined , and was particularly effective in African Americans and those with hypertension . The DASH combination diet may be an effective strategy for preventing and treating hypertension in a broad cross section of the population , including segments of the population at highest risk for blood pressure-related cardiovascular disease Abstract — Evidence suggests that obesity may raise blood pressure ( BP ) through oxidative stress – sensitive mechanisms and that the Dietary Approaches to Stop Hypertension combination diet ( DASH-CD ) may decrease BP by enhancing antioxidant capacity . To address this question , 12 obese patients with high-normal – to – stage 1 hypertension ( hypertensives ) and 12 lean normotensives were studied on their usual diets and after following the DASH-CD and a low-antioxidant diet in r and om sequence for 4 weeks each . Acute oxidative stress was induced by a 4-hour infusion of intralipid and heparin  . Ferric-reducing activity of plasma ( FRAP ) and plasma F2-isoprostanes were measured as biomarkers of antioxidant capacity and oxidative stress , respectively . BP was lower in obese hypertensives on the DASH-CD than on the usual and low-antioxidant diets ( −8.1±1.5/−7.4±1.6 mm Hg , P < 0.05 ) . BP did not change significantly in lean normotensives after 4 weeks on the DASH-CD but tended to rise on the low-antioxidant diet  . FRAP on usual diets was higher in lean subjects than in obese subjects . FRAP increased in obese but not lean volunteers on the DASH-CD compared with usual diet , and the group difference disappeared . F2-isoprostanes increased from baseline during intralipid and heparin in both groups on the low-antioxidant diet but not in obese hypertensives on the DASH-CD . Among free-living obese hypertensives , the DASH-CD  raises antioxidant capacity , lowers BP , and reduces oxidative stress induced by acute hyperlipidemia . The findings are consistent with evidence that elevated BP in obese subjects may reflect an imbalance between antioxidant capacity and oxidative stress that is improved by the DASH-CD CONTEXT Weight loss , sodium reduction , increased physical activity , and limited alcohol intake are established recommendations that reduce blood pressure ( BP ) . The Dietary Approaches to Stop Hypertension ( DASH ) diet also lowers BP . To date , no trial has evaluated the effects of simultaneously implementing these lifestyle recommendations . OBJECTIVE To determine the effect on BP of 2 multicomponent , behavioral interventions . DESIGN , SETTING , AND PARTICIPANTS R and omized trial with enrollment at 4 clinical centers ( January 2000-June 2001 ) among 810 adults ( mean [ SD ] age , 50 [ 8.9 ] years ; 62 % women ; 34 % African American ) with above-optimal BP , including stage 1 hypertension ( 120 - 159 mm Hg systolic and 80 - 95 mm Hg diastolic ) , and who were not taking antihypertensive medications . INTERVENTION Participants were r and omized to one of 3 intervention groups : ( 1 ) " established , " a behavioral intervention that implemented established recommendations ( n = 268 ) ; ( 2 ) " established plus DASH,"which also implemented the DASH diet ( n = 269 ) ; and ( 3 ) an " advice only " comparison group ( n = 273 ) . MAIN OUTCOME MEASURES Blood pressure measurement and hypertension status at 6 months . RESULTS Both behavioral interventions significantly reduced weight , improved fitness , and lowered sodium intake . The established plus DASH intervention also increased fruit , vegetable , and dairy intake . Across the groups , gradients in BP and hypertensive status were evident . After subtracting change in advice only , the mean net reduction in systolic BP was 3.7 mm Hg ( P<.001 ) in the established group and 4.3 mm Hg ( P<.001 ) in the established plus DASH group ; the systolic BP difference between the established and established plus DASH groups was 0.6 mm Hg ( P = .43 ) . Compared with the baseline hypertension prevalence of 38 % , the prevalence at 6 months was 26 % in the advice only group , 17 % in the established group ( P = .01 compared with the advice only group ) , and 12 % in the established plus DASH group ( P<.001 compared with the advice only group ; P = .12 compared with the established group ) . The prevalence of optimal BP ( < 120 mm Hg systolic and < 80 mm Hg diastolic ) was 19 % in the advice only group , 30 % in the established group ( P = .005 compared with the advice only group ) , and 35 % in the established plus DASH group ( P<.001 compared with the advice only group ; P = .24 compared with the established group ) . CONCLUSION Individuals with above-optimal BP , including stage 1 hypertension , can make multiple lifestyle changes that lower BP and reduce their cardiovascular disease risk BACKGROUND The effect of dietary composition on blood pressure is a subject of public health importance . We studied the effect of different levels of dietary sodium , in conjunction with the Dietary Approaches to Stop Hypertension ( DASH ) diet , which is rich in vegetables , fruits , and low-fat dairy products , in persons with and in those without hypertension . METHODS A total of 412 participants were r and omly assigned to eat either a control diet typical of intake in the United States or the DASH diet . Within the assigned diet , participants ate foods with high , intermediate , and low levels of sodium for 30 consecutive days each , in r and om order . RESULTS Reducing the sodium intake from the high to the intermediate level reduced the systolic blood pressure by 2.1 mm Hg ( P<0.001 ) during the control diet and by 1.3 mm Hg ( P=0.03 ) during the DASH diet . Reducing the sodium intake from the intermediate to the low level caused additional reductions of 4.6 mm Hg during the control diet ( P<0.001 ) and 1.7 mm Hg during the DASH diet ( P<0.01 ) . The effects of sodium were observed in participants with and in those without hypertension , blacks and those of other races , and women and men . The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level ; and the difference was greater with high sodium levels than with low ones . As compared with the control diet with a high sodium level , the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension , and 11.5 mm Hg lower in participants with hypertension . CONCLUSIONS The reduction of sodium intake to levels below the current recommendation of 100 mmol per day and the DASH diet both lower blood pressure substantially , with greater effects in combination than singly . Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods High blood pressure increases the risks of stroke , dementia , and neurocognitive dysfunction . Although aerobic exercise and dietary modifications have been shown to reduce blood pressure , no r and omized trials have examined the effects of aerobic exercise combined with dietary modification on neurocognitive functioning in individuals with high blood pressure ( ie , prehypertension and stage 1 hypertension ) . As part of a larger investigation , 124 participants with elevated blood pressure ( systolic blood pressure 130 to 159 mm Hg or diastolic blood pressure 85 to 99 mm Hg ) who were sedentary and overweight or obese ( body mass index : 25 to 40 kg/m2 ) were r and omized to the Dietary Approaches to Stop Hypertension ( DASH ) diet alone , DASH combined with a behavioral weight management program including exercise and caloric restriction , or a usual diet control group . Participants completed a battery of neurocognitive tests of executive function-memory-learning and psychomotor speed at baseline and again after the 4-month intervention . Participants on the DASH diet combined with a behavioral weight management program exhibited greater improvements in executive function-memory-learning ( Cohen 's D=0.562 ; P=0.008 ) and psychomotor speed ( Cohen 's D=0.480 ; P=0.023 ) , and DASH diet alone participants exhibited better psychomotor speed ( Cohen 's D=0.440 ; P=0.036 ) compared with the usual diet control . Neurocognitive improvements appeared to be mediated by increased aerobic fitness and weight loss . Also , participants with greater intima-medial thickness and higher systolic blood pressure showed greater improvements in executive function-memory-learning in the group on the DASH diet combined with a behavioral weight management program . In conclusion , combining aerobic exercise with the DASH diet and caloric restriction improves neurocognitive function among sedentary and overweight/obese individuals with prehypertension and hypertension
Changes in both systolic and diastolic BP were greater in participants with higher baseline BP or BMI .
The DASH diet improved cardiovascular risk factors and appeared to have greater beneficial effects in subjects with an increased cardiometabolic risk .
The DASH diet is an effective nutritional strategy to prevent CVD
The Dietary Approach to Stop Hypertension ( DASH ) is recommended to lower blood pressure ( BP ) , but its effects on cardiometabolic biomarkers are unclear .
A systematic review and meta- analysis of r and omised controlled trials ( RCT ) was conducted to determine the effects of the DASH diet on cardiovascular risk factors .