The sodium-restricted DASH diet reduced clinic systolic blood pressure from 155 to 138 mm Hg (P=0.02) and improved arterial stiffness and oxidative stress in patients with hypertensive HFPEF.
Does the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) reduce blood pressure, arterial stiffness, and oxidative stress in patients with treated hypertension and compensated HFPEF?
A sodium-restricted DASH diet significantly reduces systemic blood pressure, arterial stiffness, and oxidative stress in patients with hypertensive HFpEF over 21 days.
Absolute Event Rate: 138% vs 155%
p-value: p=0.02
Recent studies suggest that oxidative stress and vascular dysfunction contribute to heart failure with preserved ejection fraction (HFPEF). In salt-sensitive HFPEF animal models, diets low in sodium and high in potassium, calcium, magnesium, and antioxidants attenuate oxidative stress and cardiovascular damage. We hypothesized that the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) would have similar effects in human hypertensive HFPEF. Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD for 21 days (all food/most beverages provided). The DASH/SRD reduced clinic systolic (155-138 mm Hg; P=0.02) and diastolic blood pressure (79-72 mm Hg; P=0.04), 24-hour ambulatory systolic (130-123 mm Hg; P=0.02) and diastolic blood pressure (67-62 mm Hg; P=0.02), and carotid-femoral pulse wave velocity (12.4-11.0 m/s; P=0.03). Urinary F2-isoprostanes decreased by 31% (209-144 pmol/mmol Cr; P=0.02) despite increased urinary aldosterone excretion. The reduction in urinary F2-isoprostanes closely correlated with the reduction in urinary sodium excretion on the DASH/SRD. In this cohort of HFPEF patients with treated hypertension, the DASH/SRD reduced systemic blood pressure, arterial stiffness, and oxidative stress. These findings are characteristic of salt-sensitive hypertension, a phenotype present in many HFPEF animal models and suggest shared pathophysiological mechanisms linking these 2 conditions. Further dietary modification studies could provide insights into the development and progression of hypertensive HFPEF.
Hummel et al. (Tue,) conducted a other in Hypertensive heart failure with preserved ejection fraction (HFPEF) (n=13). Sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) vs. Baseline was evaluated on Clinic systolic blood pressure (p=0.02). The sodium-restricted DASH diet reduced clinic systolic blood pressure from 155 to 138 mm Hg (P=0.02) and improved arterial stiffness and oxidative stress in patients with hypertensive HFPEF.