9/16/2020 Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure

od pressure and cardiovascular biomarkers in me…

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Randomized Controlled Trial Arch Intern Med. 2010 Jan 25;170(2):126-35.

doi: 10.1001/archinternmed.2009.470.

Effects of the DASH diet alone and in combination

with exercise and weight loss on blood pressure and
cardiovascular biomarkers in men and women with
high blood pressure: the ENCORE study
James A Blumenthal  1 , Michael A Babyak, Alan Hinderliter, Lana L Watkins, Linda Craighead, Pao-Hwa
Lin, Carla Caccia, Julie Johnson, Robert Waugh, Andrew Sherwood

Affiliations
PMID: 20101007 PMCID: PMC3633078 DOI: 10.1001/archinternmed.2009.470
Free PMC article

Abstract
Background: Although the DASH (Dietary Approaches to Stop Hypertension) diet has been shown to
lower blood pressure (BP) in short-term feeding studies, it has not been shown to lower BP among
free-living individuals, nor has it been shown to alter cardiovascular biomarkers of risk.

Objective: To compare the DASH diet alone or combined with a weight management program with
usual diet controls among participants with prehypertension or stage 1 hypertension (systolic BP, 130-
159 mm Hg; or diastolic BP, 85-99 mm Hg).

Design and setting: Randomized, controlled trial in a tertiary care medical center with assessments at
baseline and 4 months. Enrollment began October 29, 2003, and ended July 28, 2008.

Participants: Overweight or obese, unmedicated outpatients with high BP (N = 144).

Interventions: Usual diet controls, DASH diet alone, and DASH diet plus weight management.

Outcome measures: The main outcome measure is BP measured in the clinic and by ambulatory BP
monitoring. Secondary outcomes included pulse wave velocity, flow-mediated dilation of the brachial
artery, baroreflex sensitivity, and left ventricular mass.

Results: Clinic-measured BP was reduced by 16.1/9.9 mm Hg (DASH plus weight management);

11.2/7.5 mm (DASH alone); and 3.4/3.8 mm (usual diet controls) (P < .001). A similar pattern was
observed for ambulatory BP (P < .05). Greater improvement was noted for DASH plus weight
management compared with DASH alone for pulse wave velocity, baroreflex sensitivity, and left
ventricular mass (all P < .05).

Conclusion: For overweight or obese persons with above-normal BP, the addition of exercise and
weight loss to the DASH diet resulted in even larger BP reductions, greater improvements in vascular
and autonomic function, and reduced left ventricular mass.
https://pubmed.ncbi.nlm.nih.gov/20101007/ 1/2
9/16/2020 Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in me…

Clinical trial registration: clinicaltrials.gov Identifier: NCT00571844.

Figures

Figure 2 5 Comparison of Figure 3 5 Comparison of

Figure 1 5 Participant
posttreatment means posttreatment means
flow in the ENCORE…
and… and…

Figure 4 5 Comparison of
posttreatment mean
(95%…

Comment in
Tackling obesity: is primary care up to the challenge?
Kushner RF.
Arch Intern Med. 2010 Jan 25;170(2):121-3. doi: 10.1001/archinternmed.2009.479.
PMID: 20101005 No abstract available.

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https://pubmed.ncbi.nlm.nih.gov/20101007/ 2/2