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Does the DASH diet lower blood pressure by altering peripheral vascular function?

Abstract

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, aiming 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.

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References

  1. Kannel WB . Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA 1996; 275: 1571–1576.

    Article  CAS  Google Scholar 

  2. Himmelmann A, Hedner T, Hansson L, O′Donnell CJ, Levy D . Isolated systolic hypertension: an important cardiovascular risk factor. Blood Press 1998; 7: 197–207.

    Article  CAS  Google Scholar 

  3. Lackland DT, Egan BM . The dominant role of systolic hypertension as a vascular risk factor: evidence from the southeastern United States. Am J Med Sci 1999; 318: 365–368.

    Article  CAS  Google Scholar 

  4. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ . Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–1360.

    Article  Google Scholar 

  5. Staessen JA, Wang J-G, Thijs L . Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet 2001; 358: 1305–1315.

    Article  CAS  Google Scholar 

  6. Collaboration BPLTT, Turnbull F, Neal B, Ninomiya T, Algert C, Arima H et al. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. BMJ 2008; 336: 1121–1123.

    Google Scholar 

  7. Krousel-Wood MA, Muntner P, He J, Whelton PK . Primary prevention of essential hypertension. Med Clin North Am 2004; 88: 223–238.

    Article  Google Scholar 

  8. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–1124.

    Article  CAS  Google Scholar 

  9. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001; 344: 3–10.

    Article  CAS  Google Scholar 

  10. Conlin PR, Erlinger TP, Bohannon A, Miller 3rd ER, Appel LJ, Svetkey LP et al. The DASH diet enhances the blood pressure response to losartan in hypertensive patients. Am J Hypertens 2003; 16: 337–342.

    Article  CAS  Google Scholar 

  11. Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller 3rd ER, Lin P-H et al. Effects on blood lipids of a blood pressure-lowering diet: the dietary approaches to stop hypertension (DASH) trial. Am J Clin Nutr 2001; 74: 80–89.

    Article  CAS  Google Scholar 

  12. Ard JD, Grambow SC, Liu D, Slentz CA, Kraus WE, Svetkey LP . The effect of the PREMIER interventions on insulin sensitivity. Diabetes Care 2004; 27: 340–347.

    Article  Google Scholar 

  13. Harsha DW, Sacks FM, Obarzanek E, Svetkey LP, Lin PH, Bray GA et al. Effect of dietary sodium intake on blood lipids: results from the DASH-sodium trial. Hypertension 2004; 43: 393–398.

    Article  CAS  Google Scholar 

  14. Lund-Johansen P . Newer thinking on the hemodynamics of hypertension. Curr Opin Cardiol 1994; 9: 505–511.

    Article  CAS  Google Scholar 

  15. Vogel RA, Corretti MC, Plotnick GD . The postprandial effect of components of the Mediterranean diet on endothelial function. J Am Coll Cardiol 2000; 36: 1455–1460.

    Article  CAS  Google Scholar 

  16. Azadbakht L, Kimiagar M, Mehrabi Y, Esmaillzadeh A, Hu FB, Willett WC . Soy consumption, markers of inflammation, and endothelial function: a cross-over study in postmenopausal women with the metabolic syndrome. Diabetes Care 2007; 30: 967–973.

    Article  CAS  Google Scholar 

  17. Coppack SW, Evans RD, Fisher RM, Frayn KN, Gibbons GF, Humphreys SM et al. Adipose tissue metabolism in obesity: lipase action in vivo before and after a mixed meal. Metabolism 1992; 41: 264–272.

    Article  CAS  Google Scholar 

  18. Summers LKM, Samra JS, Humphreys SM, Morris RJ, Frayn KN . Subcutaneous abdominal adipose tissue blood flow: variation within and between subjects and relationship to obesity. Clin Sci 1996; 91: 679–683.

    Article  CAS  Google Scholar 

  19. Karpe F, Fielding BA, Ilic V, Macdonald IA, Summers LK, Frayn KN . Impaired postprandial adipose tissue blood flow response is related to aspects of insulin sensitivity. Diabetes 2002; 51: 2467–2473.

    Article  CAS  Google Scholar 

  20. Jansson PA, Larsson A, Lonnroth PN . Relationship between blood pressure, metabolic variables and blood flow in obese subjects with or without non-insulin-dependent diabetes mellitus. Eur J Clin Invest 1998; 28: 813–818.

    Article  CAS  Google Scholar 

  21. Ardilouze J, Fielding B, Currie J, Frayn K, Karpe F . Nitric oxide and beta-adrenergic stimulation are major regulators of pre- and postprandial subcutaneous adipose tissue blood flow in humans. Circulation 2004; 109: 47–52.

    Article  CAS  Google Scholar 

  22. Tan GD, Neville MJ, Liverani E, Humphreys SM, Currie JM, Dennis AL et al. The in vivo effects of the Pro12Ala PPARγ2 polymorphism on adipose tissue NEFA metabolism: the first use of the Oxford Biobank. Diabetologia 2006; 49: 158–168.

    Article  CAS  Google Scholar 

  23. Schofield WN . Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr: Clin Nutr 1985; 39C: 5–41.

    Google Scholar 

  24. Bland M . An Introduction to Medical Statistics, 2nd edn. Oxford University Press: Oxford, 1995.

    Google Scholar 

  25. Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB . Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 2008; 168: 713–720.

    Article  Google Scholar 

  26. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F . Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005; 28: 2823–2831.

    Article  CAS  Google Scholar 

  27. Bickerton AS, Roberts R, Fielding BA, Tornqvist H, Blaak EE, Wagenmakers AJ et al. Adipose tissue fatty acid metabolism in insulin-resistant men. Diabetologia 2008; 51: 1466–1474.

    Article  CAS  Google Scholar 

  28. Wendelhag I, Fagerberg B, Hulthe J, Bokemark L, Wikstrand J . Endothelium-dependent flow-mediated vasodilatation, insulin resistance and the metabolic syndrome in 60-year-old men. J Intern Med 2002; 252: 305–313.

    Article  CAS  Google Scholar 

  29. Lind L . Endothelium-dependent vasodilation, insulin resistance and the metabolic syndrome in an elderly cohort: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Atherosclerosis 2008; 196: 795–802.

    Article  CAS  Google Scholar 

  30. Scuteri A, Tesauro M, Rizza S, Iantorno M, Federici M, Lauro D et al. Endothelial function and arterial stiffness in normotensive normoglycemic first-degree relatives of diabetic patients are independent of the metabolic syndrome. Nutr Metab Cardiovasc Dis 2008; 18: 349–356.

    Article  CAS  Google Scholar 

  31. Golledge J, Leicht AS, Crowther RG, Glanville S, Clancy P, Sangla KS et al. Determinants of endothelial function in a cohort of patients with peripheral artery disease. Cardiology 2008; 111: 51–56.

    Article  CAS  Google Scholar 

  32. Galetta F, Franzoni F, Plantinga Y, Ghiadoni L, Rossi M, Prattichizzo F et al. Ambulatory blood pressure monitoring and endothelium-dependent vasodilation in the elderly athletes. Biomed Pharmacother 2006; 60: 443–447.

    Article  CAS  Google Scholar 

  33. Lind L . Endothelium-dependent vasodilation in relation to different measurements of blood pressure in the elderly: the prospective investigation of the Vasculature in Uppsala Seniors study. Blood Press Monit 2008; 13: 245–250.

    Article  Google Scholar 

  34. Fuentes F, López-Miranda J, Sánchez E, Sanchez F, Paez J, Paz-Rojas E et al. Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Ann Intern Med 2001; 134: 1115–1119.

    Article  CAS  Google Scholar 

  35. Lafortuna CL, Adorni F, Agosti F, Sartorio A . Factor analysis of metabolic syndrome components in obese women. Nutr Metab Cardiovasc Dis 2008; 18: 233–241.

    Article  CAS  Google Scholar 

  36. Berrahmoune H, Herbeth B, Samara A, Marteau J-B, Siest G, Visvikis-Siest S . Five-year alterations in BMI are associated with clustering of changes in cardiovascular risk factors in a gender-dependant way: the Stanislas study. Int J Obes 2008; 32: 1279–1288.

    Article  CAS  Google Scholar 

  37. Scheen AJ, Finer N, Hollander P, Jensen MD, Van Gaal LF . Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. Lancet 2006; 368: 1660–1672.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Jane Cheeseman, Marjorie Gilbert and Sandy Humphreys for assistance with the clinical studies and the laboratory analyses. We thank Dr John Townend for helping us to establish the HRV methodology. This work was supported by the Biotechnology and Biological Sciences Research Council (UK) (grant number BB/D008123/1). LH was a Girdlers' Health Research Council New Zealand Fellow of Green College, Oxford.

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Correspondence to K N Frayn.

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Hodson, L., Harnden, K., Roberts, R. et al. Does the DASH diet lower blood pressure by altering peripheral vascular function?. J Hum Hypertens 24, 312–319 (2010). https://doi.org/10.1038/jhh.2009.65

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