Abstract MP11: Sodium Reduction in Combination With the Dietary Approaches to Stop Hypertension Diet Lowers 10-year Atherosclerotic Cardiovascular Disease Risk: Results From the Dietary Approaches to Stop Hypertension-Sodium Trial

Abstract

Introduction: The Dietary Approaches to Stop Hypertension (DASH) diet lowers estimated 10-year ASCVD (atherosclerotic cardiovascular disease) risk. The impact of sodium reduction, alone or in combination with the DASH diet, is not known. Objective: To determine the effects of the sodium reduction alone and when combined with the DASH diet on 10-year ASCVD risk. Methods: The DASH-Sodium trial randomized 412 adults with systolic blood pressure (BP) 120-159 mmHg and diastolic BP 80-95 mmHg to the DASH diet or a typical American diet (control). Within each arm, individuals consumed 3 different levels of sodium in random order: low (50 mmol/day), medium (100 mmol/day), and high (150 mmol/day). Each period lasted 4 weeks. Pooled cohort equation-estimated 10-year ASCVD risk scores were calculated at baseline and at 4, 8, and 12 weeks of feeding. Results: Among the 412 participants (mean [SD] age 48 [10] years; 57% female, 57% Black), sodium reduction decreased ASCVD risk scores in both DASH and control diets ( Figure 1 ). Compared to high sodium intake, low sodium intake changed ASCVD risk by -9.4% (95% CI -11.7, -7.0). Compared to a typical American diet, the DASH diet changed 10-year ASCVD by -5.3% (95% CI -9.3, -1.2). Compared to a high sodium-control diet, the combination of both low sodium intake with DASH changed ASCVD risk by -14.1% (95% CI -18.6, -9.3). Conclusions: Sodium reduction and the DASH diet both independently reduced 10-year ASCVD risk. Moreover, the combined impact was additive. These findings support dietary sodium reduction in addition to the DASH diet for ASCVD prevention.