![]() The opposite relationship was found, however, with meat intake. A CARDIA hypertension sub-study of 4304 subjects revealed a dose dependent inverse relationship between plant-based food consumption, including fruits, whole grains, and nuts, and blood pressure. ![]() ![]() The Coronary Artery Risk Development in Young Adults (CARDIA) study prospectively followed 5115 young (aged 18 to 30 years), black and white men and women over a 15 year time period and monitored them for the development of cardiovascular disease risk factors. ![]() The DASH collaborative research group stated that they could not identify the individual components of the DASH diet that made it effective, but other studies have shown that specific components of the DASH diet, such as fruits, vegetables, whole grains, and nuts were each associated with decreased blood pressure. The diet high in fruits and vegetables but otherwise similar to the control diet also lowered blood pressure but not to the same extent as the DASH diet. The DASH diet reduced both systolic and diastolic blood pressure by 5.5 mmHg and 3.0 mmHg, respectively, when compared to control. Patients were given standardized meals, and their weight and dietary sodium intake were kept stable. DASH, a controlled feeding study, examined three different diets: (1) a control diet, representative of a “typical” American diet, (2) the DASH diet, high in fruits and vegetables and low in saturated and total fat, and (3) a diet high in fruits and vegetables but otherwise similar to the control diet. The first, major randomized control trial to evaluate diet and hypertension was the Dietary Approaches to Stop Hypertension (DASH) study of the mid-1990s. Despite his findings, Kempner's work was not widely accepted by the scientific community, which favored randomized control trials to substantiate these findings. Similarly, in his first cohort of hypertensive patients, 107 of 192 patients demonstrated marked improvement, including decreased blood pressure, cholesterol levels, retinopathy, and cardiac silhouette size. He first demonstrated its effectiveness in a diabetic, hypertensive patient with renal and congestive heart failure: post intervention, this patient exhibited decreased cardiac silhouette size as measured by chest X-ray, normalization of a left ventricular strain pattern on ECG, and improvement in hypertensive retinopathy. Walter Kempner of Duke University introduced the “rice diet” as therapy for renal failure and hypothesized that “we could radically alter the patients' diets and thereby save lives.” The rice diet was high in complex carbohydrates, consisting mainly of rice and fruit, and low in fat, protein (< 20 g/day) and sodium (< 150 mg/day). Although the benefits of exercise and weight loss seem to be inherently understood by most, the definition and perception of a “healthy” diet is one that has not yet reached consensus. Blood pressure was significantly lower in the vegan group. This study compared the blood pressure of sedentary vegans, endurance athletes (matched for body mass index with the vegan group) consuming a Western diet and running an average of 48 miles per week, and sedentary subjects consuming a Western diet. However, results from one small cross-sectional study suggest that a plant-based diet is the more important intervention. įirst line therapies for all stages of hypertension include exercise and weight loss. In the United States, clinic visits, medications and the treatment of complications from hypertension, including heart failure, stroke, and renal disease now account for a substantial portion of the Medicare budget. In the Global Burden of Disease 2010 study, hypertension was identified as the number one risk factor worldwide for deaths and disability-adjusted life years. These findings translate into poor outcomes as the number of deaths due to hypertension increased by 35% from 2003–2013. The National Health and Nutrition Data Examination Survey found that only 54% of hypertensive adults in the United States had their high blood pressure controlled and 17% remained undiagnosed. Worldwide, it is estimated that one billion people have hypertension and approximately 80 million Americans 20 years of age and older are hypertensive. Hypertension is an insidious, common, and deadly disease, often detected incidentally at a routine doctor's visit or workplace health screening.
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