In the Dietary Approach to Stop Hypertension (DASH) trial, the DASH diet reduced blood pressure (BP) in a diverse sample of US adults. Subsequent analyses of this trial documented the efficacy of the DASH diet in several subgroups. Although subgroup analyses in individuals with metabolic syndrome (MS) have not been performed, the DASH diet has been recommended in MS patients. This paper is a subgroup analysis of the DASH trial, in which we examined the effect of study diets on BP in participants with and without MS. Participants were stratified according to MS status (99 with MS, 311 without MS (Non-MS)). The trial was a dietary intervention study in which participants were randomized to receive a control diet, a diet rich in fruits and vegetables, or the DASH diet. Outcomes were (i) the difference in BP between the end and the beginning of intervention and (ii) control of hypertension. We found no significant interaction between MS status and diet assignment on BP (each P-interaction >0.05). In the MS subgroup, the DASH diet compared with the control diet reduced systolic BP by 4.9 mm Hg (P=0.006) and diastolic BP by 1.9 mm Hg (P=0.15). In the Non-MS subgroup, corresponding net BP reductions were 5.2 mm Hg (P<0.001) and 2.9 mm Hg (P<0.001), respectively. The DASH diet controlled hypertension in 75% of hypertensive participants with MS (adjusted odds ratio=9.5 vs the control diet, P=0.05). In conclusion, the DASH diet similarly reduces BP in those with and without MS. Our findings provide direct evidence for existing recommendations.
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This work was supported by a Fulbright Grant (15043737) from the Institute of International Education to Dr Fadi Hikmat. This work was also supported by the late Mr Hikmat A Bihnam. The DASH clinical trial was supported by Grants (HL50981, HL50968, HL50972, HL50977, HL50982, HL02642, RR02635 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. We are indebted to the trial participants for their sustained commitment to DASH, and to the following companies, which donated food: Best Foods, Campbell’s Soup Company, Coca-Cola Foods Company, Comstock Michigan Fruit, The Dannon Company, Dole Food Company, HJ Heinz Company, Harris Teeter Company, Hershey Foods Corporation, Lifelines Technology Inc., McCormick & Company Inc., Nabisco Foods Group, Ocean Spray Cranberries Inc., Procter & Gamble, Quaker Oats Company, Ralston Foods, Sunkist Growers, Vandenbergh Foods and Wawona Frozen Foods.
The authors declare no conflict of interest.
Supplementary Information accompanies this paper on the Journal of Human Hypertension website
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Hikmat, F., Appel, L. Effects of the DASH diet on blood pressure in patients with and without metabolic syndrome: results from the DASH trial. J Hum Hypertens 28, 170–175 (2014). https://doi.org/10.1038/jhh.2013.52
- metabolic syndrome
- blood pressure
- dietary intervention study
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