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January 17, 2012 3:25 pm
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Dietary patterns and blood pressure
Lawrence J. Appel, et al. A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure, NEJM, 1997; 336:117-1124.
Compared to a control diet described as typical of the American diet, this 30-day controlled feeding trial demonstrated significant blood pressure falls for those with elevated blood pressure (inlcuding hypertensives). Hypertensives, for example, decreased SBP by 11.4 mmHg, equivalent to taking two anti-hypertensive drugs. Salt intake was held constant.
In 2001, a second trial, DASH-Sodium, found that those on the "DASH Diet" who also reduced their sodium intake by 60% to about 1,500 mg/day Na reduced their SBP by 11.5 mmHg. NHLBI, which funded the study, declared this proof that salt reduction is an effective population intervention. Subgroup analysis of the DASH-Sodium trial revealed that there was no statistically-significant BP effect of the severe salt reduction in six of the eight reported subgroups (no subgroup for overweight was reported).