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Wed, Apr 24, 2019

Hypertension
The Health Benefits of Fruits and Vegetables



Hypertension or high blood pressure affects over 50 million people in the United States (34). The well-publicized Dietary Approaches to Stop Hypertension (DASH) Trial showed that fruit and vegetable intake, (8.5 servings or more per day) particularly in combination with low-fat dairy products, effectively lowers blood pressure in subjects with normal and high blood pressure (45). High blood pressure is typically defined as systolic blood pressure greater than 140 mm Hg or diastolic blood pressure over 90 mm Hg. Recently, a detailed report of the effects of the DASH diet on subgroups of subjects with Stage 1 hypertension (systolic 140-159 mm Hg and/or diastolic blood pressure 90-95 mm Hg) was published (57). The DASH combination diet, including high fruit and vegetable intake, low-fat dairy products, whole grains, poultry, fish, and nuts was effective in controlling hypertension in 70% of the participants with Stage 1 hypertension. A diet high in fruits and vegetables also lowered blood pressure in this group but to a lesser extent. Results were observed within 2 weeks of dietary modification and were sustained throughout the 8-week intervention period.


Subjects with normal diastolic but elevated systolic blood pressure (> 140 mm Hg) are designated as having “isolated systolic hypertension” or ISH. ISH is probably the most common form of untreated hypertension and is associated with increased risk of cardiovascular death (58). In a recent report analyzing a DASH Trial subgroup (n=72) with ISH, it was found that the 8-week DASH diet was effective in reducing both systolic and diastolic blood pressure.


These data from the DASH Trial suggest that diets including a high intake of fruits and vegetables are effective at reducing blood pressure in subgroups of the population with various forms of hypertension. The nutrients accounting for the reduction in blood pressure have not been defined but potassium likely accounts for the effects observed with fruit and vegetable intake. A number of studies have also suggested that flavonoids in fruits and vegetables are protective for stroke, for which hypertension is a major risk factor (59). Whether flavonoids directly affect blood pressure is unknown.


Hypertension is associated with increased risk of CVD, stroke, and renal dysfunction. The data from the DASH Trial show that diets incorporating fruits and vegetables are an important first line of defense against these conditions.


“… Hypertension is associated with increased risk of CVD, stroke, and renal dysfunction. The data from the DASH Trial show that diets incorporating fruits and vegetables are an important first line of defense against these conditions.”

 

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