p358 THE JOURNAL OF CLINICAL HYPERTENSION VOL. 11 NO. 7 JULY 2009
ASH Position Paper: Dietary Approaches to Lower Blood Pressure
Lawrence J. Appel, MD, MPH, on Behalf of the American Society of Hypertension Writing Group
Edited by Dr SJ Dodgson from position paper prepared : From the Department of Medicine, Division ofGeneral Internal Medicine, Johns Hopkins University,Baltimore, MDAddress for correspondence:Lawrence J. Appel, MD, MPH, Johns HopkinsUniversity, 2024 East Monument Street, Suite 2-618,Baltimore, MD 21205-2223E-mail: lappel@jhmi.eduManuscript received October 31, 2008;accepted November 6, 2008----------------------------------------------------------Well-established risk factors for elevated BP include -excess salt intake -low potassium intake -excess weight -high alcohol consumption, and - suboptimal dietary pattern. African Americans are especially sensitiveto the BP-raising effects of excess salt intake,insufficient potassium intake, and suboptimaldiet. BP rises with age in both children and adults. BP increases with severity of cardiovascular-renal diseases. In nonhypertensives, dietary changes can lower BP and delay, if not prevent,hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatmentbefore drug therapy. In hypertensive individuals on drug therapy, lifestyle modificationscan further lower BP. The current challenge is designing and implementing effective clinical andpublic health interventions that lead to sustaineddietary changes among individuals and morebroadly in the general population. J ClinHypertens (Greenwich). 2009;11:358–368.ª2009 Wiley Periodicals, Inc.
CONCLUSIONS
Multiple dietary factors affect BP. Dietary modifications
that lower BP are weight loss, reduced salt
intake, increased potassium intake, moderation of
alcohol consumption (among those who drink),
and consumption of an overall healthy dietary pattern,
similar to a DASH-style diet.
Other aspects of diet may also affect BP, but the effects are small
and⁄or the evidence is uncertain .
In view of the age-related rise in BP in both children
and adults, the direct progressive relationship
of BP with cardiovascular-renal diseases throughout
the usual range of BP, and the worldwide epidemic
of BP-related disease, efforts to reduce BP in both
nonhypertensive and hypertensive individuals are
warranted. Such efforts will require individuals to
change behavior and society to make substantial
environmental changes.
The current challenge is
designing and implementing effective clinical and
public health interventions that lead to sustained
dietary changes among individuals and more
broadly in the general population.
Download position paper from http://www.ash-us.org/documents/DietaryApproachesLowerBP.pdf
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