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Low Concordance with the DASH Plan Is Associated with Higher Cardiovascular Risk in Treated Hypertensive Patients

DOI: 10.1155/2014/618710

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Abstract:

This study aimed at analyzing the alimentary habits of treated hypertensive patients identifying the degree of concordance with Dietary Approaches to Stop Hypertension (DASH) plan. Anthropometry and blood pressure (BP) were evaluated, and the 10-year risk for general cardiovascular disease was estimated and used to calculate vascular age. A DASH concordance score was obtained using food frequency questionnaire and the cut-off points were established for eight food groups. Subjects were divided into two groups according to the median of DASH concordance score: lower concordance (LC group < 4.5 points, ) and higher concordance (HC group ≥ 4.5 points, ). LC group was associated with higher BP, vascular age, and cardiovascular risk. DASH concordance score was positively correlated with intake of fiber, calcium, potassium, and magnesium ( ) and negatively correlated with BP, cardiovascular risk, and vascular age ( ). After logistic regression adjusted for age and gender, only cardiovascular risk ( , ) was independently associated with DASH concordance score. Hypertensive patients with dietary patterns less concordant with the DASH plan had higher BP levels and increased cardiovascular risk, indicating the relevance of management in the treatment of these patients. 1. Introduction The adoption of a healthy lifestyle, with a reduced dietary fat and salt intake, is one of the main actions that must be implemented in hypertensive patients [1, 2]. The Dietary Approaches to Stop Hypertension (DASH) plan has been recognized among the numerous recommendations regarding nonpharmacological management for reducing blood pressure (BP) levels. The DASH diet encourages the increased consumption of foods containing fibers, protein, calcium, potassium, and magnesium and the restriction of cholesterol, total, and saturated fat. Thus, a greater intake of fruits, vegetables, grains, low-fat dairy products, nuts, legumes, and lean meats has been suggested, along with a reduction in the consumption of fat, red meat, sweets, and sugar-containing beverages [3]. The exact mechanism of action related to the DASH plan is not completely elucidated. Combined foods according to this eating plan may provide an important strategy to control BP especially in the prehypertensive stage (systolic BP 120–139?mmHg and/or diastolic BP 80–89?mmHg) or stage I hypertension (systolic BP 140–159?mmHg and/or diastolic BP 90–99?mmHg). However, the role of these dietary factors, alone or in combination, in BP regulation remains controversial [4]. Other potential benefits of the DASH diet include

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