Abstract
BackgroundHypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern.MethodsThe PREDIMED primary prevention trial is a randomized, single-blinded, controlled trial conducted in Spanish primary healthcare centers. We recruited 7,447 men (aged 55 to 80 years) and women (aged 60 to 80 years) who had high risk for cardiovascular disease. Participants were assigned to a control group or to one of two Mediterranean diets. The control group received education on following a low-fat diet, while the groups on Mediterranean diets received nutritional education and also free foods; either extra virgin olive oil, or nuts. Trained personnel measured participants’ BP at baseline and once yearly during a 4-year follow-up. We used generalized estimating equations to assess the differences between groups during the follow-up.ResultsThe percentage of participants with controlled BP increased in all three intervention groups (P-value for within-group changes: P<0.001). Participants allocated to either of the two Mediterranean diet groups had significantly lower diastolic BP than the participants in the control group (−1.53 mmHg (95% confidence interval (CI) −2.01 to −1.04) for the Mediterranean diet supplemented with extra virgin olive oil, and −0.65 mmHg (95% CI -1.15 to −0.15) mmHg for the Mediterranean diet supplemented with nuts). No between-group differences in changes of systolic BP were seen.ConclusionsBoth the traditional Mediterranean diet and a low-fat diet exerted beneficial effects on BP and could be part of advice to patients for controlling BP. However, we found lower values of diastolic BP in the two groups promoting the Mediterranean diet with extra virgin olive oil or with nuts than in the control group.Trial registrationCurrent Controlled Trials ISRCTN35739639
Highlights
Hypertension can be prevented by adopting healthy dietary patterns
The PREDIMED primary prevention trial showed that a dietary intervention designed to foster adherence to the traditional Mediterranean diet (MD) significantly reduced the risk of Cardiovascular disease (CVD) clinical end-points [8]
Of the 7,447 participants recruited to the PREDIMED trial, 289 were excluded either because there was no information on their baseline blood pressure (BP) or they had extreme BP values
Summary
Hypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern. In 2003, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure estimated that hypertension affects approximately 1 billion people worldwide [1]. This condition is a major risk factor for stroke, ischemic heart disease, and other chronic cardiovascular diseases (CVDs) [2]. High-quality overall dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) diet, can be of utmost importance in the prevention and treatment of hypertension [5] Of these high-quality dietary patterns, one in particular has received much recent attention because of the growing evidence for its role in cardiovascular protection, namely, the traditional Mediterranean diet (MD) [6]. Only two studies had a follow-up time beyond 2 years, and the largest of the two had a sample size of 605 subjects [9]
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