A recent Clinical Nutrition study conducted a clinical trial to match the favored diets, namely, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean weight-reduction plan (MedDiet), together with a salt-restricting strategy for reducing hypertension (BP) and hypertension.

Background

Ineffective BP control strategies are a outstanding risk factor for premature mortality and morbidity worldwide. An uncontrolled BP increases the danger of complications suh as cardiovascular events and chronic kidney disease.

Individuals with grade 1 hypertension and low-moderate heart problems are beneficial to intake less salt and adopt non-pharmaceutical interventions to administer hypertension. Recent meta-analyses of randomized controlled trials (RCTs) have correlated salt intake with BP level. Low salt intake can improve BP levels.

Besides salt intake, each DASH and MedDiet are related to effective BP reduction in adults with or without hypertension. Each the weight-reduction plan types beneficial a high intake of plant-based foods and a low intake of red and processed meat.

In comparison with the DASH weight-reduction plan, the MedDiet is high in total fat resulting from the inclusion of olive oil. Subsequently, for patients with high BP, the DASH weight-reduction plan has proved to be more practical than the MedDiet. 

Although the American College of Cardiology/American Heart Association (ACC/AHA) beneficial the DASH weight-reduction plan as a heart-healthy weight-reduction plan in 2017, it was contradicted by the European Society of Cardiology/European Society of Hypertension (ESC/ESH) in 2018. The ESC/ESH beneficial the MedDiet to be a healthy weight-reduction plan that may be easily practiced for a protracted period.

The DASH weight-reduction plan with salt restriction exhibited a better BP reduction. Nonetheless, it should be noted that this combining strategy isn’t commonly practiced. Up to now, no studies have indicated the effectiveness of MedDiet with salt restriction. Moreover, there may be a necessity for a comparative study to evaluate the effectiveness of the DASH weight-reduction plan and MedDiet in lowering BP.

Concerning the study

The present randomized, single-center, controlled, single-blinded study compared the effectiveness of the DASH weight-reduction plan and the MedDiet based on a three-month intervention period. A complete of 4 parallel groups, i.e., control group (CG), salt restriction group (SRG), DASH weight-reduction plan combined with salt restriction group (DDG), and MedDiet combined with salt restriction group (MDG), were formed with a 1:1:1:1 allocation. 

Participants (18 to 65 years of age) who visited the Hypertension Unit of the Hippokration General Hospital of Athens for the primary time were chosen for this study.

All participants had a high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg), grade 1 hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg), or low-moderate heart problems risk.

Nonetheless, none of them were under antihypertensive drug treatment or had a history of major medical conditions. At baseline, BP was measured, fasting blood samples were collected, and ambulatory blood pressure monitoring (ABPM) was performed.

Study findings

A complete of 240 participants were randomly assigned to one in all the 4 trial groups. The 4 study groups didn’t differ when it comes to demographic and clinical characteristics at baseline.

Moreover, at baseline, ~48% of the study cohort had high normal BP, and ~51% had grade 1 hypertension. The mean baseline BP (systolic/diastolic) was 137/88 mmHg, and the baseline 24-hour ambulatory BP (systolic/diastolic) was 133/83.

The first assessment after three months of intervention revealed that, apart from CG, all other intervention groups exhibited improvement in systolic and diastolic pressure. In comparison with SRG, each the DDG and the MDG exhibited a greater reduction in systolic BP.

Moreover, in comparison with the DDG, the MDG revealed a greater reduction of systolic BP values. All intervention groups exhibited a big reduction in diastolic BP. Each the DDG and the MDG intervention exhibited similar 24-hour ambulatory systolic and diastolic BP values.

Compared to CG, all other intervention groups indicated marginal odds of hypertension. Amongst interventions, the DDG and MDG exhibited lower odds of hypertension, with 65% and 84% odds, respectively, in comparison with the SRG.

In relation to the baseline levels, the best reduction in office systolic BP was present in MDG and diastolic was present in the DDG.

Conclusions

In sum, the MedDiet was found to be more practical in reducing office systolic BP in comparison with the DASH weight-reduction plan, while the DASH weight-reduction plan exhibited equal effectiveness for the reduction in office diastolic BP.

After three months of intervention, the DASH and the MedDiet exhibited similar 24-hour ambulatory systolic and diastolic BP values. Notably, dietary patterns combined with salt restriction exhibited probably the most effective lead to BP improvement. 

In the long run, more studies are required to analyze the heart problems risk and other outcomes linked to MedDiet and the DASH weight-reduction plan combined with salt restriction. An extended clinical trial should be conducted to know the effectiveness of every intervention higher.