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Journal of Nutrition and Metabolism
Volume 2012, Article ID 472396, 10 pages
http://dx.doi.org/10.1155/2012/472396
Research Article

Blood Pressure-Lowering Mechanisms of the DASH Dietary Pattern

1Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA
2Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC 27710, USA
3Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
4Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA
5Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
6Duke Hypertension Center, Duke University Medical Center, Durham, NC 27710, USA

Received 6 June 2011; Accepted 7 October 2011

Academic Editor: Christel Lamberg-Allardt

Copyright © 2012 Pao-Hwa Lin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Potential blood pressure- (BP-) lowering mechanisms of the DASH dietary pattern were measured in 20 unmedicated hypertensive adults in a controlled feeding study. At screening, participants averaged 4 4 . 3 ± 7 . 8 years, BMI 3 3 . 9 ± 6 . 6  Kg/m2, and BP 1 4 4 . 2 ± 9 . 3 8 / 8 8 . 5 ± 6 . 0 3  mmHg. All consumed a control diet for one week, then were randomized to control or DASH for another two weeks (week one and two). With DASH, but not controls, SBP fell by 1 0 . 6 5 ± 1 2 . 8 9 ( 𝑃 = 0 . 0 2 3 ) and 9 . 6 0 ± 1 1 . 2 3 ( 𝑃 = 0 . 0 3 9 ) mmHg and DBP by 5 . 9 5 ± 8 . 0 1 ( 𝑃 = 0 . 0 6 9 ) and 8 . 6 0 ± 9 . 1 3  mmHg ( 𝑃 = 0 . 0 1 1 ) at the end of week one and two, respectively. Univariate regressions showed that changes in urinary sodium/potassium ratio ( 𝛽 = 1 . 9 9 ) and plasma renin activity ( 𝛽 = 1 5 . 7 8 ) and percent change in plasma nitrite after hyperemia were associated with SBP changes at week one (all 𝑃 < 0 . 0 5 ). Plasma nitrite following hyperemia showed a treatment effect ( 𝑃 = 0 . 0 1 4 ) and increased at week two ( 𝑃 = 0 . 0 0 1 ). Pulse wave velocity decreased over time with DASH (trend 𝑃 = 0 . 0 1 9 ), and reached significance at week two ( 𝑃 = 0 . 0 2 6 ). This response may be mediated by an improvement in upregulation of nitric oxide bioavailability. Early natriuresis and reductions in oxidative stress cannot be ruled out. Future studies are needed to verify these findings, assess the possibility of earlier effects, and examine other potential mediators.