The traditional Mediterranean diet supplemented with extra virgin olive oil significantly reduced diastolic blood pressure by 1.53 mmHg compared to a low-fat diet in older adults at high cardiovascular risk.
RCT (n=7,447)
Single-blind
1:1:1 ratio by means of a computer-generated random-number sequence
Yes
Does a Mediterranean diet supplemented with extra virgin olive oil or nuts reduce blood pressure compared to a low-fat diet in older adults at high risk for cardiovascular disease?
A Mediterranean diet supplemented with extra virgin olive oil or nuts provides a modest but significant reduction in diastolic blood pressure compared to a low-fat diet in patients at high cardiovascular risk.
Mean Difference: -1.53 (95% CI -2.01–-1.04)
p-value: p=<0.001
BACKGROUND: Hypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern. METHODS: The PREDIMED primary prevention trial is a randomized, single-blinded, controlled trial conducted in Spanish primary healthcare centers. We recruited 7,447 men (aged 55 to 80 years) and women (aged 60 to 80 years) who had high risk for cardiovascular disease. Participants were assigned to a control group or to one of two Mediterranean diets. The control group received education on following a low-fat diet, while the groups on Mediterranean diets received nutritional education and also free foods; either extra virgin olive oil, or nuts. Trained personnel measured participants' BP at baseline and once yearly during a 4-year follow-up. We used generalized estimating equations to assess the differences between groups during the follow-up. RESULTS: The percentage of participants with controlled BP increased in all three intervention groups (P-value for within-group changes: P<0.001). Participants allocated to either of the two Mediterranean diet groups had significantly lower diastolic BP than the participants in the control group (-1.53 mmHg (95% confidence interval (CI) -2.01 to -1.04) for the Mediterranean diet supplemented with extra virgin olive oil, and -0.65 mmHg (95% CI -1.15 to -0.15) mmHg for the Mediterranean diet supplemented with nuts). No between-group differences in changes of systolic BP were seen. CONCLUSIONS: Both the traditional Mediterranean diet and a low-fat diet exerted beneficial effects on BP and could be part of advice to patients for controlling BP. However, we found lower values of diastolic BP in the two groups promoting the Mediterranean diet with extra virgin olive oil or with nuts than in the control group. TRIAL REGISTRATION: Current Controlled Trials ISRCTN35739639.
Toledo et al. (Thu,) conducted a rct in High cardiovascular risk (n=7,447). Mediterranean diet supplemented with extra virgin olive oil or mixed nuts vs. Low-fat control diet was evaluated on Change in diastolic blood pressure (MD+EVOO vs Control) (MD -1.53 mmHg, 95% CI -2.01 to -1.04, p=<0.001). The traditional Mediterranean diet supplemented with extra virgin olive oil significantly reduced diastolic blood pressure by 1.53 mmHg compared to a low-fat diet in older adults at high cardiovascular risk.