DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study

Crystal C. Tyson, Clemontina A. Davenport, Pao Hwa Lin, Julia J. Scialla, Rasheeda Hall, Clarissa J. Diamantidis, Joseph Lunyera, Nrupen Bhavsar, Casey M. Rebholz, Jane Pendergast, L. Ebony Boulware, Laura P. Svetkey

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD. METHODS: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status. RESULTS: Among participants (mean age: 55 years; hypertension: 60%; CKD: 19%), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95% confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg. CONCLUSIONS: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.

Original languageEnglish (US)
Pages (from-to)975-982
Number of pages8
JournalAmerican journal of hypertension
Volume32
Issue number10
DOIs
StatePublished - Sep 24 2019

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Chronic Renal Insufficiency
Diet
Blood Pressure
Hypertension
Health Behavior
Linear Models
Sodium

Keywords

  • Black American
  • blood pressure
  • chronic kidney disease
  • diet
  • hypertension
  • nutrition

ASJC Scopus subject areas

  • Internal Medicine

Cite this

DASH Diet and Blood Pressure Among Black Americans With and Without CKD : The Jackson Heart Study. / Tyson, Crystal C.; Davenport, Clemontina A.; Lin, Pao Hwa; Scialla, Julia J.; Hall, Rasheeda; Diamantidis, Clarissa J.; Lunyera, Joseph; Bhavsar, Nrupen; Rebholz, Casey M.; Pendergast, Jane; Boulware, L. Ebony; Svetkey, Laura P.

In: American journal of hypertension, Vol. 32, No. 10, 24.09.2019, p. 975-982.

Research output: Contribution to journalArticle

Tyson, CC, Davenport, CA, Lin, PH, Scialla, JJ, Hall, R, Diamantidis, CJ, Lunyera, J, Bhavsar, N, Rebholz, CM, Pendergast, J, Boulware, LE & Svetkey, LP 2019, 'DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study', American journal of hypertension, vol. 32, no. 10, pp. 975-982. https://doi.org/10.1093/ajh/hpz090
Tyson, Crystal C. ; Davenport, Clemontina A. ; Lin, Pao Hwa ; Scialla, Julia J. ; Hall, Rasheeda ; Diamantidis, Clarissa J. ; Lunyera, Joseph ; Bhavsar, Nrupen ; Rebholz, Casey M. ; Pendergast, Jane ; Boulware, L. Ebony ; Svetkey, Laura P. / DASH Diet and Blood Pressure Among Black Americans With and Without CKD : The Jackson Heart Study. In: American journal of hypertension. 2019 ; Vol. 32, No. 10. pp. 975-982.
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abstract = "BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD. METHODS: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status. RESULTS: Among participants (mean age: 55 years; hypertension: 60{\%}; CKD: 19{\%}), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95{\%} confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg. CONCLUSIONS: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.",
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T1 - DASH Diet and Blood Pressure Among Black Americans With and Without CKD

T2 - The Jackson Heart Study

AU - Tyson, Crystal C.

AU - Davenport, Clemontina A.

AU - Lin, Pao Hwa

AU - Scialla, Julia J.

AU - Hall, Rasheeda

AU - Diamantidis, Clarissa J.

AU - Lunyera, Joseph

AU - Bhavsar, Nrupen

AU - Rebholz, Casey M.

AU - Pendergast, Jane

AU - Boulware, L. Ebony

AU - Svetkey, Laura P.

PY - 2019/9/24

Y1 - 2019/9/24

N2 - BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD. METHODS: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status. RESULTS: Among participants (mean age: 55 years; hypertension: 60%; CKD: 19%), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95% confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg. CONCLUSIONS: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.

AB - BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD. METHODS: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status. RESULTS: Among participants (mean age: 55 years; hypertension: 60%; CKD: 19%), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95% confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg. CONCLUSIONS: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.

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KW - chronic kidney disease

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KW - hypertension

KW - nutrition

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