Hypertension: diet and little salt are better than beta-blockers

Combining a low-salt diet with the “cardioprotective” principles of the DASH diet has been shown to be particularly effective in reducing systolic blood pressure.

The DASH (Dietary Approaches to Stop Hypertension) diet, long promoted by the National Heart, Lung, and Blood Institute and the American Heart Association, is rich in fruits, vegetables, whole grains, lean dairy products, fish, poultry, legumes, nuts and seeds. It has already been widely proven to be effective in reducing blood pressure, just like a low-salt diet. The purpose of this new study, conducted at Johns Hopkins University School of Medicine, was to assess the combined effects of these two approaches in adults with early or mild forms of high blood pressure, i.e. group at high risk of developing a more severe form of hypertension.

The effects of the diet vary according to the degree of hypertension

For 12 weeks, 412 adults with a systolic blood pressure (BP) of 120 to 159 mm Hg followed either a DASH diet or a control diet, close to that of the average for the American population. Sodium intake was modified randomly over four-week periods, with low (1150 mg sodium per day), medium (2300 mg/d) or high (3450 mg/d). Participants were classified into groups according to their baseline systolic PS.

The results, published in the Journal of the American College of Cardiology, show that the DASH diet leads to a reduction in PS which is all the greater the higher the starting PS. However, the most spectacular results appear for the combination of the DASH diet and a low sodium intake.

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At least as effective as beta blockers

Thus, while the DASH diet alone reduces systolic PS by only 4 mm Hg in those with the lowest baseline PS (120-129 mm Hg), the reduction is 11 mm Hg in those with a PS of 150 to 159 mm Hg. And when those with the highest starting PS combine DASH diet and low sodium intake, that’s an average reduction of 21 mm Hg, compared to the control diet. To situate the importance of these results, the authors explain that the Food and Drug Administration requires, for any new antihypertensive drug submitted for approval, a reduction in systolic PS of 3-4 mm Hg. And that the most widely used drugs, beta-blockers, on average reduce systolic PS by 10-15 mm Hg.


Juraschek S et al. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. J Am Coll Cardiol. doi.org/10.1016/j.jacc.2017.10.011

keywords: hypertension, DASH diet, salt, beta-blockers, blood pressure,

meta: Combining a low-salt diet with the “cardioprotective” principles of the DASH diet has been shown to be particularly effective in reducing systolic blood pressure. The decreases in blood pressure observed are even better than those obtained by specific drugs for hypertension; beta blockers.

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