DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study

Overview

Journal Am J Hypertens

Publisher Oxford University Press

Specialty Cardiology & Vascular Diseases

Date 2019 Jun 13

PMID 31187128

Citations 7

Authors

Crystal C Tyson

Clemontina A Davenport

Pao-Hwa Lin

Julia J Scialla

Rasheeda Hall

Clarissa J Diamantidis

Joseph Lunyera

Nrupen Bhavsar

Casey M Rebholz

Jane Pendergast

L Ebony Boulware

Laura P Svetkey

Affiliations

Soon will be listed here.

Abstract

Background: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD.

Methods: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status.

Results: Among participants (mean age: 55 years; hypertension: 60%; CKD: 19%), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95% confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg.

Conclusions: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.

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