Diet Change Tops for Reducing CVD Risk in Stage 1 Hypertension

Healthy lifestyle changes to reduce systolic blood pressure to below 130 mm Hg may prevent 26,000 heart attacks and strokes and reduce healthcare costs over the next 10 years, a new simulation study suggests.

Among the various lifestyle changes, adopting the Dietary Approaches to Stop Hypertension diet, known as the DASH diet, may have the greatest impact for young and middle-aged adults with stage 1 hypertension.

Dr Kendra Sims

"This research reveals that we should look to feasible ways our food system could make healthy eating the default option," Kendra Sims, PhD, MPH, postdoctoral fellow at University of California San Francisco, told theheart.org | Medscape Cardiology.

"Above all, it means collaborating with the patient about nourishing choices that fit best into their culture and lifestyle," Sims said.

Be Proactive

"What is important is that people not wait until they have hypertension to start thinking about healthful diets," commented Taylor Wallace, PhD, Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia, who was not involved in the study.

"It's all about prevention in my mind. Whether you are hypertensive or are perfectly healthy, the DASH diet or any other dietary pattern that emphasizes consumption of fruits, vegetables, whole grains, lean meats, seafood, nuts/seeds, and low/non-fat dairy and decreased intake of saturated fats, added sugars, and sodium is a good idea," Wallace told theheart.org | Medscape Cardiology.

The study was released this week ahead of presentation tomorrow at the American Heart Association (AHA) Hypertension Scientific Sessions 2022 in San Diego.

Sims and colleagues used US statistics from multiple sources to simulate CVD events, mortality, and healthcare costs between 2018 and 2027 in adults aged 35-64 years with untreated stage 1 hypertension, defined as systolic BP of 130 to 139 mm Hg.

The researchers estimate that 8.8 million US adults (5.5 million women) aged 35-64 years have untreated stage 1 hypertension and would be recommended for lifestyle change, such as physical activity, weight loss, moderating alcohol intake, and adoption of the DASH diet.

Controlling blood pressure to less than 130 mm Hg in this population could prevent 26,000 CVD events, avoid 2900 deaths, and lead to $1.6 billion in associated healthcare costs, the researchers calculate.

The largest benefit would come from adoption of the DASH diet, with an estimated 15,000 CVD events prevented among men and 11,000 among women.

Even Small Changes Can Help

"Young and middle-aged adults with stage 1 hypertension aren't as low risk as you — or even your doctor — might think," Sims told theheart.org | Medscape Cardiology.

"Millions of working-aged people are walking around with elevated blood pressure, which is symptomless but is also a leading preventable cause of disability and death. Most do not follow the recommended DASH diet," Sims said

"Unfortunately, the availability and affordability of healthy food sources does not easily allow people to follow the DASH diet," Sims adds in a conference news release.

"Clinicians should consider whether their patients live in food deserts or places with limited walkability. Health counseling should include addressing these specific challenges to blood pressure control," Sims says.

Wallace noted that diet changes don't have to be drastic.

"Honestly, just increasing fruit and vegetable intake has been shown to displace calories from saturated fats, added sugars, and sodium," he told theheart.org | Medscape Cardiology.

"It's hard for people to stick to 'diets' long-term, so shifting toward healthier dietary patterns without having to read a book on the DASH diet or count calories and carbs seems like a more practical solution for the general population, although I have no issues with the DASH diet and think it is a great dietary pattern for heart health," Wallace said.

The study had no funding. Sims reports no relevant financial relationships. Wallace is principal and CEO of Think Healthy Group; chief food and nutrition scientist with Produce for Better Health Foundation; editor, Journal of Dietary Supplements; deputy editor, Journal of the American College of Nutrition; nutrition section editor, Annals of Medicine; and advisory board member with Forbes Health.

American Heart Association (AHA) Hypertension Scientific Sessions 2022: Abstract 137. To be presented September 10, 2022.

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