TY - JOUR
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
AU - Lunyera, Joseph
AU - Bhavsar, Nrupen
AU - Rebholz, Casey M.
AU - Pendergast, Jane
AU - Boulware, Leigh
AU - Svetkey, Laura P.
N1 - Funding Information:
The Jackson Heart Study is supported by contracts HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, and HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities. C.C.T is supported by a supplemental training award from the National Heart, Lung, Blood Institute (R01HL122836). C.A.D. is partially supported by the Duke Clinical and Translational Science Award (UL1TR001117). C.M.R. is supported by a mentored research scientist development award from the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107782).
Publisher Copyright:
© American Journal of Hypertension, Ltd 2019. All rights reserved.
PY - 2019/11/1
Y1 - 2019/11/1
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.
KW - Black American
KW - Blood pressure
KW - Chronic kidney disease
KW - Diet
KW - Hypertension
KW - Nutrition
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U2 - 10.1093/ajh/hpz090
DO - 10.1093/ajh/hpz090
M3 - Article
C2 - 31187128
AN - SCOPUS:85072627860
SN - 0895-7061
VL - 32
SP - 975
EP - 982
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 10
ER -