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Comparative Study
. 2019 Sep 24;32(10):975-982.
doi: 10.1093/ajh/hpz090.

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

Crystal C Tyson  1 , Clemontina A Davenport  2 , Pao-Hwa Lin  1 , Julia J Scialla  1   3 , Rasheeda Hall  1 , Clarissa J Diamantidis  1 , Joseph Lunyera  1 , Nrupen Bhavsar  1 , Casey M Rebholz  4 , Jane Pendergast  2 , L Ebony Boulware  1 , Laura P Svetkey  1
Affiliations
Comparative Study

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

Crystal C Tyson et al. Am J Hypertens. .

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.

Keywords: Black American; blood pressure; chronic kidney disease; diet; hypertension; nutrition.

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Figures

Figure 1.
Figure 1.
Flowchart for Jackson Heart Study participants included and excluded from analysis. CKD, chronic kidney disease.
Figure 2.
Figure 2.
Frequency distribution for the DASH score among Jackson Heart Study participants. DASH, Dietary Approaches to Stop Hypertension.
Figure 3.
Figure 3.
Effect modification of CKD status on DASH score and blood pressure among Jackson Heart Study participants. Models were adjusted for age, sex, income, education, smoking status, alcohol use, physical activity, body mass index, use of antihypertensive medication, diet, CKD status (yes/no), and diet × CKD interaction term. BP, blood pressure; CKD, chronic kidney disease; DASH, Dietary Approaches to Stop Hypertension; DBP, diastolic BP; SBP, systolic BP.
Figure 4.
Figure 4.
Effect modification of albuminuria on DASH score and blood pressure among Jackson Heart Study participants. Models were adjusted for age, sex, income, education, smoking status, alcohol use, physical activity, body mass index, use of antihypertensive medication, estimated glomerular filtration rate, albuminuria (yes/no), and diet × albuminuria interaction term. Albuminuria is defined as urine albumin-to-creatinine ratio ≥30 mg/g. BP, blood pressure; DASH, Dietary Approaches to Stop Hypertension; DBP, diastolic BP; SBP, systolic BP.
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References

    1. Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G, O’Connor A, Perumal K, Rahman M, Steigerwalt S, Teal V, Townsend R, Weir M, WrightJT, Jr.. Chronic Renal Insufficiency Cohort Study I: hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 2010; 55:441–451. - PMC - PubMed
    1. Hsu CY, McCulloch CE, Darbinian J, Go AS, Iribarren C. Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165:923–928. - PubMed
    1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, MohlerER, 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee . Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation 2015; 131:e29–322. - PubMed
    1. Saran R, Robinson B, Abbott KC, Agodoa LYC, Bragg-Gresham J, Balkrishnan R, Dietrich X, Eckard A, Eggers PW, Gaipov A, Gillen D, Gipson D, Hailpern SM, Hall YN, Han Y, He K, Herman W, Heung M, Hirth RA, Hutton D, Jacobsen SJ, Jin Y, Kalantar-Zadeh K, Kapke A, Kovesdy CP, Lavallee D, Leslie J, McCullough K, Modi Z, Molnar MZ, Montez-Rath M, Moradi H, Morgenstern H, Mukhopadhyay P, Nallamothu B, Nguyen DV, Norris KC, O’Hare AM, Obi Y, Park C, Pearson J, Pisoni R, Potukuchi PK, Rao P, Repeck K, Rhee CM, Schrager J, Schaubel DE, Selewski DT, Shaw SF, Shi JXM, Shieu M, Sim JJ, Soohoo M, Steffick D, Streja E, Sumida K, Tamura MK, Tilea A, Tong L, Wang DY, Wang M, Woodside KJ, Xin X, Yin MG, You AS, Zhou H, Shahinian V. US renal data system 2017 annual data report epidemiology of kidney disease in the United States. Am J Kidney Dis 2018; 71:S1–S676. - PMC - PubMed
    1. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N. A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative research group. N Engl J Med 1997; 336:1117–1124. - PubMed

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