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The effects of dietary patterns on plasma renin activity: results from the Dietary Approaches to Stop Hypertension trial

Abstract

A diet rich in fruits, vegetables and low-fat dairy products, and reduced in saturated fat, total fat and cholesterol (the ‘DASH’ diet) significantly lowers blood pressure (BP). Previous studies have documented that certain therapies that lower BP increase plasma renin activity (PRA). Using data from the Dietary Approaches to Stop Hypertension (DASH) trial, we assessed the effects of dietary patterns on PRA and determined the relationship of change in PRA with change in BP on each diet. After eating a control diet for 3 weeks, participants were then randomized to receive for 8 weeks: the control diet, a diet rich in fruits and vegetables (F/V), or the DASH diet. Baseline and follow-up levels of PRA were available in 381 participants. Compared with the control diet, the DASH diet increased PRA by 0.37 ng ml−1 h−1 (P=0.01). In multivariable linear regression analyses, there was an inverse association of PRA change with systolic BP change on the control diet (slope=−0.35, P=0.001), but PRA did not differ by BP change on the F/V diet (slope=−0.002, P=0.98) or DASH diet (slope=−0.08, P=0.32). These data suggest that a blunted counter-regulatory response of the renin–angiotensin system is associated with the BP-lowering effect of the F/V and DASH diets.

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Acknowledgements

The DASH Collaborative Research group is extremely appreciative of trial participants for their persistent commitment to DASH and of the following companies who donated food: Best Foods, Campbell's Soup Co, Coca-Cola Foods Co, Comstock Michigan Fruit, The Dannon Co, Dole Food Co, HJ Heinz Co, Harris Teeter Co, Hershey Foods Corp, Lifelines technology, Inc, McCormick & Co, Inc, Nabisco Foods Group, Ocean Spray Cranberries, Inc, Procter & Gamble, Quaker Oats Company, Ralston Foods, Sunkist Growers, Vandenbergh Foods and Wawona Frozen Foods. The DASH trial was supported by grants (HL50981, HL50968, HL50972, HL50977, HL50982, HL02642, RR02642 and RR00722) from the National Heart, Lung, and Blood Institute, the Office of Research on Minority Health and the National Center for Research Resources of the National Institutes of health.

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Correspondence to L J Appel.

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Chen, Q., Turban, S., Miller, E. et al. The effects of dietary patterns on plasma renin activity: results from the Dietary Approaches to Stop Hypertension trial. J Hum Hypertens 26, 664–669 (2012). https://doi.org/10.1038/jhh.2011.87

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