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Chronobiologic assessment of the effect of the DASH diet on blood pressure

Journal of Human Hypertension volume 35, pages 678–684 (2021)Cite this article

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Abstract

This study compares the effect of three diets on the circadian rhythm of blood pressure (BP). Hypertension and abnormal BP variability (BPV) are major risk factors leading to morbidity and mortality from cardiovascular disease. When detected early, a dietary approach may be preferred to medication. Data stemming from ambulatory BP monitoring (ABPM) from the Dietary Approaches to Stop Hypertension (DASH) study were re-analyzed from a chronobiologic perspective. Compared to the control diet (N = 112) that had no effect on BP (from 131.2/83.5 to 131.0/83.6 mmHg), both the Fruit and Vegetable (FV; N = 113) diet and the DASH (N = 113) diet were associated with a decrease in BP (FV: from 132.6/84.4 to 129.0/82.1 mmHg; DASH: from 131.9/83.6 to 127.2/80.9 mmHg). The decrease in BP was found to be circadian stage-dependent, and to differ between men and women. Nighttime BP was decreased to a larger extent with the DASH than with the FV diet, a difference observed in women but not in men. Study participants who had a higher BP during the reference stage were more likely to decrease their BP to a larger extent after the 8-week dietary intervention. The FV and DASH diets had different effects on BPV. In view of the relatively large day-to-day variability in BP in both normotensive and hypertensive people, it is recommended to monitor BP around the clock for longer than 24 h, and to individualize the optimization of dietary or other intervention.

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Fig. 1: Flowchart illustrating criteria used to select 24-h ABPM records for chronobiologic analysis.
Fig. 2: As compared to reference values derived from clinically healthy peers matched by gender and age, the incidence of an elevated 24-h average (MESOR) SBP and DBP MESORs is slightly reduced on the DASH vs. Control (C) diet, not seen with the fruit and vegetable (FV) diet (left).
Fig. 3: Reconstructed circadian waveforms of systolic (top) and diastolic (bottom) blood pressure during the reference (dashed curves) and diet (solid curves) stage.
Fig. 4: The decrease in blood pressure resulting from the DASH or FV diet was not the same during the 24-h day.
Fig. 5: Overall, most study participants on the fruit and vegetable (FV) or DASH diet responded with a decrease in systolic (top) and diastolic (bottom) blood pressure.

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References

  1. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am College Cardiol. 2017; 70:1–25. https://doi.org/10.1016/j.jacc.2017.04.052.

  2. Yu E, Rimm E, Qi L, Rexrode K, Albert CM, Sun Q, et al. Diet, lifestyle, biomarkers, genetic factors, and risk of cardiovascular disease in the Nurses’ Health Studies. Am J Public Health. 2016;106:1616–23.

    Article  Google Scholar 

  3. Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, McCullough M, et al. Rationale and design of the Dietary Approaches to Stop Hypertension Trial (DASH): a multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol. 1995;5:108–18.

    Article  CAS  Google Scholar 

  4. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. Clinical trial of the effects of dietary patterns on blood pressure. N. Engl J Med. 1997;336:1117–24.

    Article  CAS  Google Scholar 

  5. Moore TJ, Vollmer WM, Appel LJ, Sacks FM, Svetkey LP, Vogt TM, et al. Effect of dietary patterns on ambulatory blood pressure. Results from the Dietary Approaches to Stop Hypertension (DASH) trial. Hypertension. 1999;34:472–7.

    Article  CAS  Google Scholar 

  6. Cornelissen G. Cosinor-based rhythmometry. Theor Biol Med Modell. 2014;11:16. https://doi.org/10.1186/1742-4682-11-16.

  7. Halberg F, Powell D, Otsuka K, Watanabe Y, Beaty LA, Rosch P, et al. Diagnosing vascular variability anomalies, not only MESOR-hypertension. Am J Physiol Heart Circ Physiol. 2013;305:H279–94.

    Article  CAS  Google Scholar 

  8. Bingham C, Arbogast B, Cornelissen Guillaume G, Lee JK, Halberg F. Inferential statistical methods for estimating and comparing cosinor parameters. Chronobiologia. 1982;9:397–439.

    CAS  PubMed  Google Scholar 

  9. Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N. Engl J Med. 2001;345:1291–7.

    Article  CAS  Google Scholar 

  10. Márquez-Celedonio FG, Téxon-Fernández O, Chávez-Negrete A, Hernández-López S, Marín-Rendón S, Berlín-Lascurain S. Clinical effect of lifestyle modification on cardiovascular risk in prehypertensives: PREHIPER I study. Rev Esp Cardiol. 2009;62:86–90.

    Article  Google Scholar 

  11. Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R, et al. Food consumption and its impact on cardiovascular disease: importance of solutions focused on the globalized food system: a report from the workshop convened by the World Heart Federation. J Am Coll Cardiol. 2015;66:1590–614.

    Article  Google Scholar 

  12. Otsuka K, Watanabe H, Cornelissen G, Shinoda M, Uezono K, Kawasaki T, et al. Gender, age and circadian blood pressure variation of apparently healthy rural vs. metropolitan Japanese. Chronobiologia. 1990;17:253–65.

    CAS  PubMed  Google Scholar 

  13. Maas AH, Appelman YE. Gender differences in coronary heart disease. Neth Heart J. 2010;18:598–602.

    Article  CAS  Google Scholar 

  14. Ingelsson E, Björklund-Bodegård K, Lind L, Arnlöv J, Sundström J. Diurnal blood pressure pattern and risk of congestive heart failure. JAMA. 2006;295:2859–66.

    Article  CAS  Google Scholar 

  15. Yano Y, Kario K. Nocturnal blood pressure and cardiovascular disease: a review of recent advances. Hypertens Res. 2012;35:695–701.

    Article  Google Scholar 

  16. Otsuka K, Cornelissen G, Halberg F. Predictive value of blood pressure dipping and swinging with regard to vascular disease risk. Clin Drug Investig. 1996;11:20–31.

    Article  Google Scholar 

  17. Otsuka K, Cornelissen G, Halberg F, Oehlert G. Excessive circadian amplitude of blood pressure increases risk of ischemic stroke and nephropathy. J Med Eng Technol. 1997;21:23–30.

    Article  CAS  Google Scholar 

  18. Watanabe Y, Halberg F, Otsuka K, Cornelissen G. Toward a personalized chronotherapy of high blood pressure and a circadian overswing. Clin Exp Hypertens. 2013;35:257–66.

    Article  CAS  Google Scholar 

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Acknowledgements

The authors thank Professor Lloyd J. Edwards and the NIH for access to the data.

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Halberg Chronobiology Fund (GC).

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  1. Halberg Chronobiology Center, Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA

    Fatimatou Saka & Germaine Cornelissen

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  1. Fatimatou Saka
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Correspondence to Germaine Cornelissen.

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Saka, F., Cornelissen, G. Chronobiologic assessment of the effect of the DASH diet on blood pressure. J Hum Hypertens 35, 678–684 (2021). https://doi.org/10.1038/s41371-020-00408-0

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