Recommendations Summary
HTN: Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern 2008
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
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Recommendation(s)
HTN: DASH Diet
Individuals should adopt the Dietary Approaches to Stop Hypertension (DASH) dietary pattern which is rich in fruits, vegetables, low-fat dairy, and nuts; low in sodium, total fat, and saturated fat; and adequate in calories for weight management. The DASH dietary pattern reduces systolic blood pressure by 8-14 mmHg.
Rating: Consensus
Imperative-
Risks/Harms of Implementing This Recommendation
None.
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Conditions of Application
In individuals with diabetes, renal disease, food allergies or gastrointestinal intolerances, Medical Nutrition Therapy should be modified accordingly.
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Potential Costs Associated with Application
None.
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Recommendation Narrative
- Based on the JNC 7 report, lifestyle modifications reduce blood pressure, prevent or delay the incidence of hypertension, enhance antihypertensive drug efficacy, and decrease cardiovascular risk.
- Based on the JNC 7 report, blood pressure is reduced by adoption of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern.
- Based on the JNC 7 report, the adoption of the DASH dietary pattern results in an approximate systolic blood pressure reduction of 8 - 14 mmHg.
- Based on the JNC 7 report, a 1600 mg sodium DASH dietary pattern has blood pressure effects similar to single drug therapy in some individuals, and combinations of two or more lifestyle modifications can achieve even better results.
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Recommendation Strength Rationale
The ADA Hypertension Expert Work Group concurs with the recommendations from the JNC 7, regarding DASH dietary pattern.
- Updated from The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997; 157:2413-46.
- Published in The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. JAMA 2003;289:2560-71.
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Minority Opinions
Consensus reached.
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Risks/Harms of Implementing This Recommendation
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Supporting Evidence
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
- References
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References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N for the DASH Collaborative Research Group. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997;336(16):1117-24.
The Seventh Report of the Joint National Commitee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, NIH Publication No. 04-5230, August 2004, produced by the National Heart, Lung and Blood Institute in cooperation with the National High Blood Pressure Education Program.
Available at:
http://www.nhlbi.nih.gov/guidelines/hypertension/
To access the pdf of the JNC 7, click here:
http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm
To access the pdf of the DASH Eating Plan, click here: