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Abstract

African-Americans (AA) tend to have higher nocturnal BP than non-AAs. We assessed the effects, alone and combined, of sodium (Na) reduction and the DASH diet (rich in fruits, vegetables, and low fat dairy products; reduced in fat) on daytime and nighttime ABP in 335 adults (58% AA) with random-zero BP of 120-159/80-95 mmHg. Individuals were randomly assigned to the DASH or control diet. Within diet, participants were fed 3 Na levels [higher (Hi), intermediate (I) and lower (Lo)], each for 30 days in random order. ABP was obtained at the end of each Na period. Mean urine Na excretion (mEq/day) was 142 in Hi, 107 in I, and 65 in Lo. In both AA and non-AA, Na reduction (H to L) and the DASH diet lowered daytime and nighttime systolic ABP (See table). Na reduction from H to L in the control diet reduced daytime systolic BP to a greater extent in AA than non-AA (p<0.01); otherwise, there were no significant differences in daytime or nighttime BP reductions between AA and non-AA. The effect of both interventions combined was greater than the effects of either alone in both AA and non-AA. The pattern of results for diastolic ABP was similar (data not shown). In summary, Na reduction and the DASH diet, alone or combined, lower daytime and nighttime BP in both AA and non-AA. These data provide additional support for recommendations to reduce Na and to promote the DASH diet as a means to lower BP in the general population.

Effects on daytime and nighttime systolic BP of sodium reduction (H to L) and DASH diet by race (adjusted for age and gender)
BP Differences within SubgroupBP Difference Between Subgroups
AANon-AAAA minus Non-AA
Sodium effect (reduction from H to L) in control diet
-Daytime-6.5**-2.4*-4.2**
-Nighttime-4.8**-6.2**1.4
DASH diet effect (net of control) at higher Na level
-Daytime-6.1**-3.4*-2.7
-Nighttime-3.1-5.8**2.7
Combined effect of Na reduction (H to L) and DASH diet
-Daytime-9.5**-6.3**-3.2
-Nighttime-7.7**-7.9**0.2
Effects on daytime and nighttime systolic BP of sodium reduction (H to L) and DASH diet by race (adjusted for age and gender)
BP Differences within SubgroupBP Difference Between Subgroups
AANon-AAAA minus Non-AA
Sodium effect (reduction from H to L) in control diet
-Daytime-6.5**-2.4*-4.2**
-Nighttime-4.8**-6.2**1.4
DASH diet effect (net of control) at higher Na level
-Daytime-6.1**-3.4*-2.7
-Nighttime-3.1-5.8**2.7
Combined effect of Na reduction (H to L) and DASH diet
-Daytime-9.5**-6.3**-3.2
-Nighttime-7.7**-7.9**0.2
*

p<0.05,

**

p<0.01

Effects on daytime and nighttime systolic BP of sodium reduction (H to L) and DASH diet by race (adjusted for age and gender)
BP Differences within SubgroupBP Difference Between Subgroups
AANon-AAAA minus Non-AA
Sodium effect (reduction from H to L) in control diet
-Daytime-6.5**-2.4*-4.2**
-Nighttime-4.8**-6.2**1.4
DASH diet effect (net of control) at higher Na level
-Daytime-6.1**-3.4*-2.7
-Nighttime-3.1-5.8**2.7
Combined effect of Na reduction (H to L) and DASH diet
-Daytime-9.5**-6.3**-3.2
-Nighttime-7.7**-7.9**0.2
Effects on daytime and nighttime systolic BP of sodium reduction (H to L) and DASH diet by race (adjusted for age and gender)
BP Differences within SubgroupBP Difference Between Subgroups
AANon-AAAA minus Non-AA
Sodium effect (reduction from H to L) in control diet
-Daytime-6.5**-2.4*-4.2**
-Nighttime-4.8**-6.2**1.4
DASH diet effect (net of control) at higher Na level
-Daytime-6.1**-3.4*-2.7
-Nighttime-3.1-5.8**2.7
Combined effect of Na reduction (H to L) and DASH diet
-Daytime-9.5**-6.3**-3.2
-Nighttime-7.7**-7.9**0.2
*

p<0.05,

**

p<0.01

salt, diet, diurnal pattern
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© American Journal of Hypertension, Ltd. 2001
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