Contents

1Clinical Question
2Bottom Line
3Major Points
4Guidelines
5Design
6Population
6.1Inclusion Criteria
6.2Exclusion Criteria
6.3Baseline Characteristics
7Interventions
8Outcomes
8.1Primary Outcome
8.2Secondary Outcomes
9Criticisms
10Funding
11Further Reading

Clinical Question

In adults with less severe hypertension (systolic blood pressures <160 mm Hg and diastolic blood pressures of 80 to 95 mm Hg), does a diet rich in fruits, vegetables, and low-fat dairy products, with reduced saturated and total fat, lower blood pressure?

Bottom Line

Major Points

Guidelines

Design

- Multicenter, randomized, controlled, feeding trial
- N=459 adults
- Three dietary groups: Control diet, Fruit and Vegetable diet, and Combination diet
- Intervention phase: 8 weeks
- Analysis: Intention-to-treat

Population

- Adults aged 22 years or older, who were not on antihypertensive medication
- Baseline systolic blood pressures <160 mm Hg; diastolic blood pressures 80 to 95 mm Hg
- Demographically diverse population: approx. 49% women, 60% black

Inclusion Criteria
- Systolic blood pressures <160 mm Hg; diastolic blood pressures 80 to 95 mm Hg
- Not taking antihypertensive medication

Exclusion Criteria
- Poorly controlled diabetes mellitus, hyperlipidemia
- Cardiovascular event within previous six months
- Body-mass index_gpt >35
- Alcohol consumption >14 drinks per week, among others

Baseline Characteristics
- Similar across the three diet groups

Interventions

- Control diet: Typical of American diets
- Fruits and vegetables diet: Higher in fruits and vegetables than the control diet
- Combination diet: Rich in fruits, vegetables, low-fat dairy products, and reduced in saturated and total fat

Outcomes

Primary Outcome
- Change in diastolic blood pressure at rest

Secondary Outcomes
- Change in systolic blood pressure and in ambulatory diastolic and systolic blood pressure

Criticisms

- Short duration of study; long-term adherence to the diet and effects on clinical cardiovascular events were not assessed.

Funding

- Grants from the National Heart, Lung, and Blood Institute, the Office of Research on Minority Health, and the National Center for Research Resources of the National Institutes of Health.

Further Reading

- Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252.