Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

Objective: To determine the effect on blood pressure of dietary advice to consume a combination of plant-based cholesterollowering foods (dietary portfolio). Methods: For 1 year, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0g/1000 kcal), soy protein (22.5g/1000 kcal), viscous fibers (10 g/ 1000 kcal) and almonds (22.5g/1000 kcal). There was no control group. Seven-day diet record, blood pressure and body weight were monitored initially monthly and later at 2-monthly intervals throughout the study. Results: Fifty subjects completed the 1-year study. When the last observation was carried forward for non-completers (n = 9) or those who changed their blood pressure medications (n 7), a small mean reduction was seen in body weight 0.7 +/- 0.3 kg (P = 0.036). The corresponding reductions from baseline in systolic and diastolic blood pressure at 1 year (n 66 subjects) were - 4.2 +/- 1.3mm Hg (P = 0.002) and - 2.3 +/- 0.7mm Hg (P = 0.001), respectively. Blood pressure reductions occurred within the first 2 weeks, with stable blood pressures 6 weeks before and 4 weeks after starting the diet. Diastolic blood pressure reduction was significantly related to weight change (r = 0.30, n= 50, P= 0.036). Only compliance with almond intake advice related to blood pressure reduction (systolic: r =- 0.34, n= 50, P =0.017; diastolic: r =- 0.29, n= 50, P= 0.041). Conclusions: A dietary portfolio of plant-based cholesterol-lowering foods reduced blood pressure significantly, related to almond intake. The dietary portfolio approach of combining a range of cholesterol-lowering plant foods may benefit cardiovascular disease risk both by reducing serum lipids and also blood pressure.