Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: A systematic review and meta-analysis on randomized controlled trials
Abstract
Background and aims Findings were not consistent on the therapeutic effect of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure. We aimed to review systematically and perform a meta-analysis to assess the magnitude of the effect of the DASH diet on blood pressure in randomized controlled trials (RCTs) among adults.Methods and results We conducted a systematic review and random effects meta-analysis of all RCTs which evaluated the effect of the DASH diet on blood pressure including published papers until June 2013, using PubMed, ISI Web of Science, Scopus and Google scholar database. Subgroup analysis and meta-regression were used to find out possible sources of between-study heterogeneity. Seventeen RCTs contributing 20 comparisons with 2561 participants were included. Meta-analysis showed that the DASH diet significantly reduced systolic blood pressure by 6.74 mmHg (95%CI: -8.25, -5.23, I(2) = 78.1%) and diastolic blood pressure by 3.54 mmHg (95%CI: -4.29, -2.79, I(2) = 56.7%). RCTs with the energy restriction and those with hypertensive subjects showed a significantly greater decrease in blood pressure. Meta-regression showed that mean baseline of SBP and DBP was explained 24% and 49% of the variance between studies for SBP and DBP, respectively.Conclusion The results revealed the profitable reducing effect of the DASH-like diet on both systolic and diastolic blood pressure in adults; although there was a variation in the extent of the fall in blood pressure in different subgroups.
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The DASH eating pattern is well established to reduce blood pressure, by 6.7/3.5 mm Hg in a recent meta-analysis.
“The Dietary Approaches to Stop Hypertension (DASH) eating pattern is well established to reduce BP, by 6.7/3.5 mm Hg in a recent meta-analysis.174,175”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [175]
A DASH-style eating pattern, alcohol restriction to <10 g/d (women) and <20 g/d (men), and a variety of other dietary modifications can each yield significant reductions in BP among patients with hypertension.
“A DASH-style eating pattern,174,175 alcohol restriction to <10 g/d (women) and <20 g/d (men),162–165 and a variety of other dietary modifications174 can each yield significant reductions in BP among patients with hypertension.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [175]
Cites
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Global burden of hypertension: analysis of worldwide data
Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. K., & He, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)17741-1 · Cited by 8,578 · see citing works
A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure
Appel, L. J., Moore, T. J., Obarzanek, E., Vollmer, W. M., Svetkey, L. P., Sacks, F. M., Bray, G. A., Vogt, T. M., Cutler, J. A., Windhauser, M. M., et al. (1997) · New England Journal of Medicine · doi:10.1056/nejm199704173361601 · Cited by 5,981 · see citing works
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101043440101 · Cited by 5,638 · see citing works
Global burden of hypertension: analysis of worldwide data
(2005) · doi:10.1016/s0140-6736(05)70151-3 · Cited by 3,289 · see citing works
Effect of lower sodium intake on health: systematic review and meta-analyses
Aburto, N. J., Ziolkovska, A., Hooper, L., Elliott, P., Cappuccio, F. P., & Meerpohl, J. J. (2013) · BMJ · doi:10.1136/bmj.f1326 · Cited by 1,242 · see citing works
Carretero, O. A., & Oparil, S. (2000) · Circulation · doi:10.1161/01.cir.101.3.329 · Cited by 1,102 · see citing works
Aburto, N., Hanson, S., Gutiérrez, H., Hooper, L., Elliott, P., & Cappuccio, F. P. (2013) · BMJ · doi:10.1136/bmj.f1378 · Cited by 956 · see citing works
Blumenthal, J. A. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.470 · Cited by 592 · see citing works
Azadbakht, L., Mirmiran, P., Esmaillzadeh, A., Azizi, T., & Azizi, F. (2005) · Diabetes Care · doi:10.2337/diacare.28.12.2823 · Cited by 536 · see citing works
Self-citationHow Far Should Salt Intake Be Reduced?
He, F. J., & MacGregor, G. A. (2003) · Hypertension · doi:10.1161/01.hyp.0000102864.05174.e8 · Cited by 379 · see citing works
Roberts, C. K., Vaziri, N. D., & Barnard, R. (2002) · Circulation · doi:10.1161/01.cir.0000040584.91836.0d · Cited by 323 · see citing works
Miller, E. R., Erlinger, T. P., Young, D. R., Jehn, M., Charleston, J., Rhodes, D., Wasan, S. K., & Appel, L. J. (2002) · Hypertension · doi:10.1161/01.hyp.0000037217.96002.8e · Cited by 319 · see citing works
Azadbakht, L., Fard, N. R. P., Karimi, M., Baghaei, M. H., Surkan, P. J., Rahimi, M., Esmaillzadeh, A., & Willett, W. C. (2011) · Diabetes Care · doi:10.2337/dc10-0676 · Cited by 304 · see citing works
Self-citationDASH Diet Lowers Blood Pressure and Lipid-Induced Oxidative Stress in Obesity
Lopes, H. F., Martin, K. L., Nashar, K., Morrow, J. D., Goodfriend, T. L., & Egan, B. M. (2003) · Hypertension · doi:10.1161/01.hyp.0000053450.19998.11 · Cited by 229 · see citing works
Straznicky, N. E., Lambert, E. A., Lambert, G. W., Masuo, K., Esler, M. D., & Nestel, P. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0961 · Cited by 227 · see citing works
Couch, S. C., Saelens, B. E., Levin, L. S., Dart, K. B., Falciglia, G. A., & Daniels, S. R. (2007) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2007.09.022 · Cited by 226 · see citing works
Asemi, Z., Tabassi, Z., Samimi, M., Fahiminejad, T., & Esmaillzadeh, A. (2012) · British Journal Of Nutrition · doi:10.1017/s0007114512004242 · Cited by 215 · see citing works
Self-citationAzadbakht, L., Kimiagar, M., Mehrabi, Y., Esmaillzadeh, A., Padyab, M., Hu, F. B., & Willett, W. C. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.735 · Cited by 178 · see citing works
Self-citationHummel, S. L., Seymour, E. M., Brook, R. D., Kolias, T. J., Sheth, S. S., Rosenblum, H. R., Wells, J. M., & Weder, A. B. (2012) · Hypertension · doi:10.1161/hypertensionaha.112.202705 · Cited by 161 · see citing works
DASH lowers blood pressure in obese hypertensives beyond potassium, magnesium and fibre
Al-Solaiman, Y., Jesri, A., Mountford, W. K., Lackland, D. T., Zhao, Y., & Egan, B. M. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2009.58 · Cited by 129 · see citing works
Avila, J. J., Gutierres, J. A., Sheehy, M. E., Lofgren, I. E., & Delmonico, M. J. (2010) · European Journal of Applied Physiology · doi:10.1007/s00421-010-1387-9 · Cited by 128 · see citing works
Hypertension Improvement Project
Svetkey, L. P., Pollak, K. I., Yancy, W. S., Dolor, R. J., Batch, B. C., Samsa, G., Matchar, D. B., & Lin, P. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.134874 · Cited by 126 · see citing works
High Dietary Sodium Intake Increases White Adipose Tissue Mass and Plasma Leptin in Rats
Fonseca‐Alaniz, M. H., Brito, L. C., Borges‐Silva, C. N., Takada, J., Andreotti, S., & Lima, F. B. (2007) · Obesity · doi:10.1038/oby.2007.261 · Cited by 121 · see citing works
The Effects of Carbohydrate, Unsaturated Fat, and Protein Intake on Measures of Insulin Sensitivity
Gadgil, M. D., Appel, L. J., Yeung, E., Anderson, C. A. M., Sacks, F. M., & Miller, E. R. (2013) · Diabetes Care · doi:10.2337/dc12-0869 · Cited by 120 · see citing works
Swain, J. F., McCarron, P. B., Hamilton, E. F., Sacks, F. M., & Appel, L. J. (2008) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2007.10.040 · Cited by 112 · see citing works
Saneei, P., Hashemipour, M., Kelishadi, R., Rajaei, S., & Esmaillzadeh, A. (2013) · British Journal Of Nutrition · doi:10.1017/s0007114513001724 · Cited by 107 · see citing works
Self-citationNowson, C. A., Wattanapenpaiboon, N., & Pachett, A. (2009) · Nutrition Research · doi:10.1016/j.nutres.2008.12.002 · Cited by 107 · see citing works
Low-sodium DASH reduces oxidative stress and improves vascular function in salt-sensitive humans
Al-Solaiman, Y., Jesri, A., Zhao, Y., Morrow, J. D., & Egan, B. M. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2009.32 · Cited by 102 · see citing works
Blood Pressure-Lowering Mechanisms of the DASH Dietary Pattern
Lin, P., Allen, J. D., Li, Y., Yu, M., Lien, L. F., & Svetkey, L. P. (2012) · Journal of Nutrition and Metabolism · doi:10.1155/2012/472396 · Cited by 87 · see citing works
Burke, V., Beilin, L. J., Christian, H. E., Mansour, J., Wilson, A., & Mori, T. A. (2005) · Journal of Hypertension · doi:10.1097/01.hjh.0000170388.61579.4f · Cited by 79 · see citing works
Edwards, K. M., Wilson, K. L., Sadja, J., Ziegler, M. G., & Mills, P. J. (2011) · Acta Physiologica · doi:10.1111/j.1748-1716.2011.02329.x · Cited by 71 · see citing works
Does the DASH diet lower blood pressure by altering peripheral vascular function?
Hodson, L., Harnden, K., Roberts, R., Dennis, A., & Frayn, K. N. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2009.65 · Cited by 68 · see citing works
Blood pressure change with weight loss is affected by diet type in men
Nowson, C. A., Worsley, A. F., Margerison, C., Jorna, M., Godfrey, S. J., & Booth, A. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.5.983 · Cited by 67 · see citing works
Blood Pressure Response to Dietary Modifications in Free-Living Individuals
Nowson, C. A., Worsley, A. F., Margerison, C., Jorna, M., Frame, A. G., Torres, S. J., & Godfrey, S. J. (2004) · Journal of Nutrition · doi:10.1093/jn/134.9.2322 · Cited by 66 · see citing works
WHO issues new guidance on dietary salt and potassium.
(2013) · PubMed · Cited by 63 · see citing works
Rocha-Goldberg, M. D. P., Corsino, L., Batch, B. C., Voils, C. I., Thorpe, C. T., Bosworth, H. B., & Svetkey, L. P. (2010) · Ethnicity and Health · doi:10.1080/13557851003674997 · Cited by 62 · see citing works
Lifestyle modification decreases the mean platelet volume in prehypertensive patients
Yazıcı, M., Kaya, A., Kaya, Y., Albayrak, S., Cinemre, H., & Özhan, H. (2009) · Platelets · doi:10.1080/09537100802613449 · Cited by 59 · see citing works
Furtado, J. D., Campos, H., Appel, L. J., Miller, E. R., Laranjo, N., Carey, V. J., & Sacks, F. M. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.6.1623 · Cited by 59 · see citing works
Harnden, K., Frayn, K. N., & Hodson, L. (2009) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2009.01007.x · Cited by 52 · see citing works
Shenoy, S. F., Poston, W. S. C., Reeves, R. S., Kazaks, A., Holt, R. R., Keen, C. L., Chen, H. J., Haddock, C. K., Winters, B., Khoo, C. S., et al. (2010) · Nutrition Journal · doi:10.1186/1475-2891-9-8 · Cited by 46 · see citing works
Whitt‐Glover, M. C., Hunter, J. C., Foy, C. G., Quandt, S. A., Vitolins, M. Z., Leng, I., Hornbuckle, L. M., Sanya, K. A., & Bertoni, A. G. (2013) · Preventing Chronic Disease · doi:10.5888/pcd10.120088 · Cited by 43 · see citing works
Corsino, L., Rocha-Goldberg, M. D. P., Batch, B. C., Ortiz-Melo, D. I., Bosworth, H. B., & Svetkey, L. P. (2012) · PubMed · Cited by 41 · see citing works
Vesco, K. K., KARANJA, N. M., King, J. C., Gillman, M. W., Perrin, N., McEvoy, C. T., Eckhardt, C. L., Smith, K., & Stevens, V. J. (2012) · Contemporary Clinical Trials · doi:10.1016/j.cct.2012.03.006 · Cited by 38 · see citing works
Woodruff, S. J., Fryer, K., Campbell, T., et al. (2013) · Public Health Nutrition · doi:10.1017/s1368980013000335 · Cited by 31 · see citing works
Dash to wellness: Emphasizing self-regulation through e-health in adults with prehypertension.
Dorough, A. E., Winett, R. A., Anderson, E. S., Davy, B. M., Martin, E. C., & Hedrick, V. E. (2012) · Health Psychology · doi:10.1037/a0030483 · Cited by 28 · see citing works
Translation and Validation of the Dietary Approaches to Stop Hypertension for Koreans Intervention
Kim, H., Song, H., Han, H., Kim, K. B., & Kim, M. T. (2013) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0b013e318262c0c1 · Cited by 27 · see citing works
Novotny, R., Nigg, C. R., McGlone, K., et al. (2012) · Food Chemistry · doi:10.1016/j.foodchem.2012.11.047 · Cited by 25 · see citing works
Lesley, M. L. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2006.07.001 · Cited by 24 · see citing works
Shenoy, S. F., Kazaks, A., Holt, R. R., Chen, H. J., Winters, B., Khoo, C. S., Poston, W. S. C., Haddock, C. K., Reeves, R. S., Foreyt, J. P., et al. (2010) · Nutrition Journal · doi:10.1186/1475-2891-9-38 · Cited by 20 · see citing works
Characteristics of Sodium Sensitivity in Korean Populations
Shin, S. J., Lim, C. Y., Rhee, M., et al. (2011) · Journal of Korean Medical Science · doi:10.3346/jkms.2011.26.8.1061 · Cited by 16 · see citing works
Kirpizidis, H. G., Stavrati, A., & Geleris, P. (2005) · PubMed · Cited by 14 · see citing works
Erlinger, T. P., Conlin, P. R., Macko, R. F., Bohannon, A., Miller, E. R., Moore, T. J., Svetkey, L. P., & Appel, L. J. (2002) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001401 · Cited by 12 · see citing works
Elevation of Morning Blood Pressure in Sodium Resistant Subjects by High Sodium Diet
Rhee, M., Lim, C., Shin, S., Oh, S.-W., Park, Y., Kim, J., Park, H.-K., Kim, C., Park, C., & Kim, S.-W. (2013) · Journal of Korean Medical Science · doi:10.3346/jkms.2013.28.4.555 · Cited by 5 · see citing works
Koley, M., Mundle, M., Ghosh, S., & Saha, S. (2013) · Cited by 5 · see citing works
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- Authors
- Saneei, P., Salehi-Abargouei, A., Esmaillzadeh, A., & Azadbakht, L.
- Affiliations
- Isfahan University of Medical Sciences (IR)
- Corresponding author
- Azadbakht, L.
- Venue
- Nutrition, Metabolism and Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 24
- Issue
- 12
- Pages
- 1253-1261
- ISSN
- 0939-4753 (ISSN-L)
- OpenAlex
- W2009648612
- Cited by
- 419
- References
- 57
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 30 · 2023: 38 · 2022: 30 · 2021: 36 · 2020: 104 · 2019: 47 · 2018: 41 · 2017: 15 · 2016: 34 · 2015: 13 · 2012: 1
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition Metabolism and Cardiovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- DASH diet, blood pressure, systolic blood pressure, diastolic blood pressure, hypertension, caloric restriction, dietary intervention
- MeSH terms
- Adult, Aged, Blood Pressure, Diet, Female, Humans, Hypertension, Male, Middle Aged, Randomized Controlled Trials as Topic
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