DASH diet may be best for reducing heart attack risk

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Following the DASH diet may have cardiovascular benefits for people with hypertension. d3sign/Getty Images
  • Overall, about one on three 30 to 79 year olds suffer from hypertension – or in other words, high blood pressure.
  • A new simulated study has found that following a DASH diet may be the most effective lifestyle intervention for reduce cardiovascular disease in people with mild hypertension.
  • The study found that this dietary change could prevent nearly 3,000 deaths in the United States alone.

The World Health Organization estimates that worldwide, 1.28 billion adults between the ages of 30 and 79 suffer from high blood pressure or hypertension. Two-thirds of them live in low- and middle-income countries. Hypertension can be a fatal disease, causing 7.5 million deaths per year.

Previous research has identified several lifestyle changes that can lower a person’s blood pressure, including dietary changes, regular exercise, and reducing alcohol consumption.

A new report finds that for people in the early stages of hypertension, diet — and diet in particular — stands out as the most effective way to maintain healthy blood pressure. The report was presented in early September at the 2022 American Heart Association Hypertension Scientific Sessions in San Diego.

According to the new report’s estimate, the DASH diet could prevent more than 15,000 heart disease events in men and 11,000 in women in the United States alone.

The report authors conducted a simulation study to assess future hypertension outcomes. About 61% of the modeled population had access to health care. About half were women.

An interdisciplinary researcher and educator, Dr. Kendra Sims, a postdoctoral fellow at the University of California, is the study’s co-principal investigator. She explained the methodology of the report to Medical News Today:

“In our case, a simulation involves extracting multiple sources of information, including the census, that reflect current and expected changes in the US population.”

“Among simulated people initially without heart disease, we incorporate risk factors from rigorous research studies of heart attacks and strokes. This method allows us to confidently project the number of people at risk of developing heart disease. heart disease over the next decade,” she said.

Blood pressure is when the blood presses outward against the walls of the arteries. Hypertension occurs when the blood exerts more pressure than is thought to be good for the arteries.

To measure a person’s blood pressure, medical professionals take two readings:

  • The measurement of systolic blood pressure records the pressure exerted on the walls of the arteries during the heartbeat.
  • The diastolic blood pressure measurement records the pressure exerted on the walls of the arteries between heartbeats.

Blood pressure is measured in millimeters of mercury – mm Hg – and expressed as the systolic measurement over the diastolic measurement.

The severity of high blood pressure can be categorized in internships:

  • High – 120-129 systolic / less than 80 diastolic
  • Stage 1 hypertension — 130-139 systolic/80-89 diastolic
  • Stage 2 hypertension – above 140 systolic / above 90 diastolic
  • Hypertensive crisis – above 180 systolic / above 120 diastolic

Hypertension is sometimes called the “invisible killer”.

“Millions of working-age people are walking around with high blood pressure,” Dr. Sims said, “which is asymptomatic, but is also one of the leading preventable causes of disability and death.”

The WHO estimates that 46% of adults with hypertension do not know they have it.

“More [hypertension patients] did not follow the recommended DASH diet. Less than two-thirds of them had regular access to health care. This was especially true for men and people between 45 and 54 years old.
—Dr. Kendra Sims

The study’s model also revealed a troubling surprise.

“We found that young and middle-aged adults with stage 1 hypertension aren’t as low a risk as you — or even your doctor — might think!” she says.

The report predicts that 8.8 million people between the ages of 35 and 64 have untreated stage 1 hypertension.

The development of DASH Diet started in the 1990s and has been refined over the years. “DASH” stands for “Dietary Approaches to Stop Hypertension”.

Dr. Jennifer Wong, medical director of noninvasive cardiology at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center, who was not involved in the study, explained the cardiological benefits of the DASH diet to DTM:

“The DASH diet promotes foods rich in potassium, magnesium, calcium, fiber and protein [as] these nutrients help lower blood pressure.

“[With the DASH diet], there is also a sodium limitation which can help lower blood pressure. Sodium is known to build up water in blood vessels and can raise blood pressure that way. And we all know that high blood pressure increases the risk of arterial thickening and heart attack, stroke, and kidney failure.
— Dr. Jennifer Wong

While the DASH diet limits the intake of saturated fat, meat and oil, Dr Wong noted: “And also interestingly, I think in addition to avoiding certain foods, it emphasizes the increase in certain foods such as fruits and vegetables.

The simulation focused on people diagnosed with mild to moderate hypertension. Dr. Wong explained the likely reason:

“This particular group is at a point where you can really prevent problems before they become more difficult to control. So you know early hypertension group 1 with high blood pressure, that’s a group where I think making a difference with lifestyle changes could really go a long way.

The researchers found that switching to a DASH diet could prevent about 2,900 deaths per year, with a reduction in national health care costs of $1.6 billion.

Michelle Routhenstein, cardiology dietitian at EntirelyNourished.com, who was also not involved in the report, told MNT:

“Examples typically used in the DASH diet may not be culturally sensitive, and they must be individualized/tailored by a qualified dietitian nutritionist for optimal success.”

Routhenstein cautioned, “I find that many people choose certain principles of the DASH diet, which can lead to missing out on much of its effectiveness.”

“In order to bring about large-scale change at a societal level,” she added, “more practical advice and implementation that makes it culturally sensitive, applicable and appetizing for each individual is essential.”

Dr Sims pointed out: “This research reveals that we should be looking for feasible ways for our food system to make healthy eating the default option.”

“It could be as simple as reducing the amount of salt in pre-packaged foods or subsidizing large-scale agriculture to grow fruits and vegetables instead of corn.”
—Dr. Kendra Sims

“Simple,” Dr. Sims said, “doesn’t mean simple. Wellness is a full-time, lifelong job. At the same time, financial and social constraints put barriers between millions of people and healthy behaviors.

“Healthcare providers and policy makers need to connect people to solutions instead of blaming them for getting sick.”

“It could be like,” Dr Sims concluded, “providing a list of local farmers’ markets that double EBT credits or confirming that someone has a working kitchen to store and prepare food. Above all, it means collaborating with the patient on healthy and delicious choices that best suit their culture and lifestyle.


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