Among several lifestyle changes that may reduce cardiovascular disease, adopting the DASH (Dietary Approaches to Stop Hypertension) diet may have the greatest impact for young and middle-aged adults with stage 1 hypertension, according to new research presented at the American Heart Association's Hypertension Scientific Sessions 2022, held Sept. 7-10, 2022.
Stage 1 hypertension is defined as having a systolic (top number) level of 130-139 mm Hg or having a diastolic (bottom number) measure of 80-89 mm Hg.
The researchers estimate widespread adoption of lifestyle changes, such as limiting heavy alcohol consumption and exercising regularly, may prevent thousands of deaths and save more than one billion dollars in health care costs over the next 10 years.
DASH diet may have greatest benefit
Their analysis found that adoption of the DASH diet could have the biggest benefit, with an estimated 15,000 heart disease events prevented among men and 11,000 event among women.
The DASH eating plan is specifically designed to help manage blood pressure. The diet emphasizes foods including fruits, vegetables, lean meat sources, whole grains, beans and lentils and nuts and seeds. It limits consumption of red meat, sodium, added sugars and sugar-sweetened beverages.
About the research
The research team estimated that 8.8 million U.S. adults, ages 35-64, have untreated stage 1 hypertension and would be recommended lifestyle changes, such as physical activity, sustained weight loss, moderating alcohol intake and adoption of the DASH diet.
In the absence of other health conditions, such as type 2 diabetes or kidney disease, and a predicted >(10%) 10-year CVD risk, people with stage 1 hypertension are considered at low risk for heart attack or stroke compared to people with stage 2 or higher hypertension.
Stage 2 hypertension is defined as systolic measures of 140 mm Hg or higher, or diastolic measures of 90 mm Hg or higher.
The recommendations for treatment for people with stage 1 hypertension is based primarily on lifestyle changes rather than medication.
Healthy lifestyles changes, especially diet, can prevent future heart disease
"Our results provide strong evidence that large-scale, healthy behavior modifications may prevent future heart disease, related complications and excess health care costs,” said the researchers.
To simulate heart disease and stroke events, mortality and health care costs between 2018 and 2027, the researchers applied evidence from published trial data about the blood-pressure reducing effects of lifestyle changes: dietary changes, sustained weight loss, physical activity, smoking cessation and alcohol moderation.
The researchers found that making recommended lifestyle changes to control blood pressure to below 130 mm Hg systolic or 90 mm Hg diastolic may have substantial health and economic benefits. They estimated that lifestyle changes could:
- Prevent 26,000 cardiovascular disease events, such as stroke, heart failure or heart attack
- Avoid 2,900 deaths
- Save $1.6 billion in associated health care costs.
"Unfortunately, the availability and affordability of healthy food sources does not easily allow people to follow the DASH diet. Clinicians should consider whether their patients live in food deserts or places with limited walkability. Health counseling should include addressing these specific challenges to blood pressure control," the researchers said.
"Members of many disadvantaged communities face barriers to healthy food and regular health care access," they said. "This means they will not be able to benefit from a counseling from a doctor. Future research should investigate the big picture: social conditions granting people the time and resources to make healthy lifestyle choices. Only with this information can we develop policies for the prevention of heart disease, especially for vulnerable adults."
Source: American Heart Association, September 7, 2022.
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