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Summary

Background

The Dietary Approaches to Cease Hypertension (DASH) diet is extensively beneficial to decrease blood stress, however its mechanisms of motion are unclear. Traces of proof recommend an interplay with the renin-angiotensin-aldosterone system (RAAS).

Goal

We carried out a randomized, managed, cross-over feeding trial to check RAAS-related mechanisms underlying the DASH diet in sufferers with remoted systolic hypertension (ClinicalTrials.gov: NCT00123006).

Strategies

Individuals entered a one-week run-in interval on a management (CON) diet after which consumed the DASH or CON diets for Four weeks every in randomized sequence. Calorie content material was managed to keep up weight, and sodium consumption was set at three g day by day. After every diet, individuals had hormonal and hemodynamic assessments obtained at baseline, in response to RAAS inhibition with captopril 25 mg (CAP), and to graded angiotensin II infusion (1 ng and three ng/kg x 45minutes). Major outcomes have been imply arterial stress (MAP) and renal blood move (RBF), and secondary outcomes have been diastolic operate, pulse wave velocity (PWV), plasma renin exercise (PRA), and aldosterone (ALDO) responses by diet.

Outcomes

In complete, 44 (19 feminine) individuals accomplished the examine. DASH + CAP considerably lowered MAP vs CON + CAP (83 ± 11 mmHg vs 88 ± 14 mmHg, p < 0.01). RBF was elevated with DASH + CAP vs CON + CAP (486 ± 149 cc/min vs 451 ± 171 cc/min, p < 0.001). Research diet didn’t change PWV however CAP diminished diastolic operate on the DASH diet (p < 0.05). DASH + CAP considerably elevated PRA vs CON + CAP (1.52 ± 1.78 ng/ml/min vs.0.89 ± 1.17 ng/ml/min; p < 0.001). ALDO sensitivity to angiotensin II infusion was better with DASH when in comparison with CON (17.4 ± 7.7 ng/ml vs 13.8 ± 6.2 ng/dl, p < 0.05) as was DASH + CAP vs CON + CAP (15.1 ± 5.three ng/dl vs 13.1 ± 5.9 ng/ml, p < 0.05).

Conclusions

The DASH diet interacts with the RAAS leading to vascular and hormonal responses much like a natriuretic impact, which seems to reinforce the hypotensive impact of ACE-inhibition in people with remoted systolic hypertension.

Notes

Sources of Help: Nationwide Institute of Well being; Nationwide Coronary heart, Lung, and Blood Institute: R01 HL77234, Nationwide Institute of Well being; Nationwide Coronary heart, Lung, and Blood Institute: Ok23 HL084236

Battle of curiosity: Stephen A. Maris, no battle of curiosity; Jonathan S. Williams, no battle of curiosity; Bei Solar, no battle of curiosity; Stacey Brown, no battle of curiosity; Gary F Mitchell, no battle of curiosity; Paul R. Conlin, no battle of curiosity

Funding Disclosures: Stephen A. Maris and Jonathan S. Williams obtained funding to journey to current these knowledge as an summary at Experimental Biology in 2018.

Authors’ info: All authors declare no conflicts of curiosity

Abbreviations: DASH, Dietary approaches to cease hypertension; CON, management. CAP, captopril; ACE, angiotensin changing enzyme; BP, blood stress; MAP, imply arterial stress; RBF, renal blood move; RAAS, Renin-Angiotensin Aldosterone system; PWV, pulse wave velocity; PRA-Plasma renin exercise; ALDO, aldosterone; PAH – para-aminohippurate; E Peak early mitral influx Doppler; e’ peak early lateral mitral annulus tissue Doppler; AngII, Angiotensin II.

Scientific Trial Registry: ClinicalTrials.gov: NCT00123006

Writer notes

Copyright © American Society for Diet 2019.