DASH lowers blood pressure in obese hypertensives beyond potassium, magnesium and fibre

The mechanism underlying blood pressure (BP) reduction in the high fruits and vegetables arm of the Dietary Approaches to Stop Hypertension (DASH) study is unknown but may include potassium, magnesium and fibre. This study was designed to separate minerals and fibre from other components of DASH on BP in abdominally obese individuals with metabolic syndrome with pre-hypertension to stage 1 hypertension (obese hypertensives). A total of 15 obese hypertensives and 15 lean normotensives were studied on a standardized usual diet, randomized to DASH or usual diet supplemented with potassium, magnesium and fibre to match DASH, then crossed over to the complementary diet. All diets were 3 weeks long, isocaloric and matched for sodium and calcium. In obese hypertensives, BP was lower after 3 weeks on DASH than usual diet (-7.6 +/- 1.4/-5.3 +/- 1.4mmHg, P<0.001/0.02) and usual diet supplemented (-6.2 +/- 1.4/-3.7 +/- 1.4 P<0.005/0.06), whereas BP was not significantly different on usual and supplemented diets. BP values were not different among the three diets in lean normotensives. Small artery elasticity was lower in obese hypertensives than in lean normotensives on the usual and supplemented diets (P<0.02). This index of endothelial function improved in obese hypertensives (P<0.02) but not lean normotensives on DASH, and was no longer different from values in lean normotensives (P>0.50). DASH is more effective than potassium, magnesium and fibre supplements for lowering BP in obese hypertensives, which suggest that high fruits and vegetables DASH lowers BP and improves endothelial function in this group by nutritional factors in addition to potassium, magnesium and fibre. Journal of Human Hypertension (2010) 24, 237-246; doi:10.1038/jhh.2009.58; published online 23 July 2009