The DASH diet enhances the blood pressure response to losartan in hypertensive patients

• Published in: American journal of hypertension 2003-05, Vol.16 (5), p.337-342
• Main Authors: Conlin, Paul R, Erlinger, Thomas P, Bohannon, Arline, Miller, Edgar R, Appel, Lawrence J, Svetkey, Laura P, Moore, Thomas J
• Format: Article
• Language: English
• Subjects: Adult; Antihypertensive agents; Antihypertensive Agents - therapeutic use; Biological and medical sciences; Biomarkers - analysis; blood pressure; Blood Pressure - drug effects; Cardiovascular system; Circadian Rhythm - physiology; Cross-Over Studies; DASH diet; Diastole - drug effects; Diet; Double-Blind Method; Female; Humans; Hypertension; Hypertension - ethnology; Hypertension - physiopathology; Hypertension - therapy; losartan; Losartan - therapeutic use; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Potassium - urine; Renin - blood; Systole - drug effects; Treatment Outcome
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(03)00056-6

The Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, and low fat dairy products, significantly lowers blood pressure (BP). We conducted a clinical trial to assess the BP response to the DASH diet with an antihypertensive medication, losartan, in participants with essential hypertension. A total of 55 hypertensive participants were randomly assigned to 8 weeks of controlled feeding with either a control diet or the DASH diet. Within each diet arm, participants received losartan 50 mg daily or placebo for 4 weeks each, in double blind, randomized, cross-over fashion. Twenty-four-hour ambulatory BP (ABP) was measured at the end of a 2-week run-in period (baseline) and after each 4-week intervention period. There was no significant change in ABP during the placebo period on the control diet ( n = 28) (−2.3 ± 1.5/−1.6 ± 1.0 mm Hg), but there was a significant reduction in systolic ABP (−5.3 ± 1.5 mm Hg, P < .05) and no change in DBP (−2.5 ± 1.0 mm Hg) on the DASH diet ( n = 27). Losartan significantly reduced ABP on the control diet (−6.7 ± 1.5/−3.7 ± 1.0 mm Hg, P < .05) and to a greater extent on the DASH diet (−11.7 ± 1.5/−6.9 ± 1.0 mm Hg, P < .05 versus basal and control diet) particularly in African Americans. On the DASH diet, ΔSBP on losartan was inversely related to basal plasma renin activity ( n = −0.53, P = .004). The DASH diet enhances the ABP response to losartan in essential hypertension. This effect is particularly marked in African Americans.