Association Between DASH Adherence and Hypertension Among Older African American Parishioners in an Underserved Urban Community

Objectives: The objective of this study was to assess and compare diet quality and adherence to DASH nutrient recommendations between hypertension and non-hypertensive older African American adults. Methods: A cross-sectional analysis was conducted using data collected between October 2021 and July 2022 from 100 African American adults aged ≥55 years. Diet was assessed using a validated food frequency questionnaire, and diet quality was quantified via the Healthy Eating Index (HEI-2015). DASH adherence was measured by comparing mean intake of sodium, potassium, magnesium, calcium, fiber, and % kcal from carbohydrates, protein, total fat, and saturated fat to DASH dietary targets. Participants self-reported hypertension status, sociodemographic, health, and food access information. Statistical analyses included t -tests and chi-square tests to compare nutrient means and adherence rates between participants with and without hypertension. Results: Participants had a mean age of 68.6 years; 71% were female, and 45% were classified as obese. The majority (74%) scored a grade of “fair” or “poor” on the HEI-2015. While HEI-2015 fruit and vegetable sub-scores met recommendations, those for sodium, added sugar, and saturated fat did not. Hypertensive participants consumed significantly more sodium than non-hypertensive ( P < .001), with the former consuming almost double their recommended amount (2884 ± 1103 vs 1500 mg). Additionally, hypertensive patients got fewer calories from carbohydrates (−3.3% kcal, P = .032), and more from protein (+2.5% kcal, P = .004) compared to their non-hypertensive peers. Neither group met potassium, calcium, magnesium, or fiber targets, with no difference between groups. About 30% reported food insecurity, yet over 70% still reported good availability of healthy foods in their neighborhood. Conclusion: Findings indicate widespread nutrient inadequacies and excessive sodium intake among older African American adults, with hypertensive participants consuming particularly high levels of sodium. Despite adequate fruit and vegetable intake and reported access to healthy foods, both groups failed to meet key DASH nutrient targets. These results highlight the need for culturally tailored, community-based interventions that specifically address sodium reduction and DASH-aligned nutrient intake to reduce cardiovascular disease risk in this underserved population.