Study: Diet Change Makes Biggest Impact on Reducing CV Risk in Those With Hypertension

Analysis presented at an American Heart Association meeting suggests that following DASH is most effective to reduce the risk of heart attacks and strokes.

Adopting the Dietary Approaches to Stop Hypertension (DASH) diet could have the greatest lifestyle change impact for young and middle-aged adults with stage 1 hypertension, according to data presented at the American Heart Association’s Hypertension Scientific Sessions 2022.

Study investigators defined stage 1 hypertension as a diastolic measure of 80 to 89 mm Hg or a systolic level of 130 to 139 mm Hg, , as set by the 2017 American Heart Association and American College of Cardiology High Blood Pressure Guideline.

Individuals with stage 1 hypertension, and without kidney disease or type 2 diabetes, are considered at low risk for heart attacks and strokes compared with those with stage 2 or higher hypertension.

The DASH eating plan, designed to help manage blood pressure (BP), emphasizes foods including fruits, grains, lean meats, nuts, seeds, and vegetables and limits consumption of red meat, sodium, sugar, and sugar-sweetened beverages.

“Nearly 9 million young and middle-aged adults with untreated stage 1 hypertension represent a significant, impending burden for health care systems,” Kendra Sims, PhD, MPH, a postdoctoral fellow at the University of California San Francisco, said in a statement. “Our results provide strong evidence that large-scale, healthy behavior modifications may prevent future heart disease, related complications and excess health care costs.”

The investigators estimated that widespread adoption of lifestyles changes, including limiting heavy alcohol consumption and exercising regularly, could prevent thousands of deaths and save more than $1 billion in health care over the next 10 years.

However, they found that the DASH diet could have the greatest benefit by preventing an estimated 15,000 heart disease events among men and 11,000 among women.

Investigators applied evidence from meta-analyses and trial data about BP reductions related to various lifestyle changes to simulate health care costs, heart disease and stroke events, and mortality between 2018 and 2027. The lifestyle changes included alcohol moderation, dietary changes, physical activity, smoking cessation, and weight loss.

Investigators found that recommending lifestyle changes to control BP to below 90 mm Hg diastolic or 130 mm Hg systolic could help prevent 26,000 cardiovascular disease events, including heart attacks, heart failure, and strokes, as well as avoiding 2900 deaths.

“Unfortunately, the availability and affordability of healthy food sources does not easily allow people to follow the DASH diet. [Physicians] should consider whether their patients live in food deserts or places with limited walkability,” Sims said.

“Health counseling should include addressing these specific challenges to [BP] control,” she said.

Many members of disadvantaged communities face barriers to health care and healthy food, which affects their ability to benefit from physician counseling, Sims said.

Further research should focus on social conditions granting individuals resources and time to make healthy lifestyle choices to help develop policies to prevent heart disease, especially for those most at risk, according to investigators.

Reference

Diet change may make biggest impact on reducing heart risk in people with hypertension. News release. EurekAlert. September 7, 2022. Accessed September 8, 2022. https://www.eurekalert.org/news-releases/963460