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New research from the University of California, San Francisco is highlighting the potential impact of optimal dietary adherence to a DASH diet on cardiovascular disease risk among young and middle-aged adults with stage 1 hypertension.
Presented at the American Heart Association’s Hypertension Scientific Sessions, results of the simulation study suggest adherence to the Dietary Approaches to Stop Hypertension (DASH) diet along with other behavior modifications could prevent up to 26,000 cardiovascular disease events and 2900 deaths while also saving $1.6 billion in associated healthcare costs over the course of a decade.
“Nearly nine million young and middle-aged adults with untreated stage 1 hypertension represent a significant, impending burden for health care systems,” said Kendra D. Sims, PhD, MPH, a postdoctoral fellow at the University of California, San Francisco and co-lead researcher of the study, in a statement. “Our results provide strong evidence that large-scale, healthy behavior modifications may prevent future heart disease, related complications and excess health care costs.”
The present study is one of many recent studies born out of the lowering of the diagnostic threshold for hypertension within the 2017 ACC/AHA guidelines. As part of these guidelines, clinicians were encouraged to counsel patients on the impact of behavior modification. Together with colleagues from UCSF, the current study was designed with an interest in assessing the potential population-level benefits of behavioral modification on cardiovascular disease risk among patients now meeting the diagnostic criteria for stage 1 hypertension. With this in mind, investigators conducted a study using the Cardiovascular Disease (CVD) Policy Model to simulate cardiovascular disease events, mortality, and healthcare costs among the aforementioned population from 2018-2027.
Using data from the 2015-2018 cycles of the National Health and Nutrition Examination Survey (NHANES), investigators identified a population of adults that was representative of 8.6 million adults aged 35-64 years with untreated stage 1 hypertension within the US. Who were defined as being lower-risk individuals based on not having diabetes, chronic kidney disease, history of cardiovascular disease, or a 10-year CVD risk exceeding 10%. Additional forms of behavior modification of interest for the present study included alcohol consumption, smoking cessation, and physical activity. For the purpose of analysis, the effects of dietary modification, sustain weight loss, physical activity, smoking cessation, and alcohol moderation were derived from published meta-analyses and trial data. Investigators pointed out that 50.6% of the estimated 8.7 million US adults included in the study were women and 61% had regular healthcare access.
Upon analysis, investigators found controlling systolic blood pressure to less than 130 mmHg in the entire target population could prevent 27,000 cardiovascular ease events, avoid 2800 deaths, and save an associated $16 million in healthcare costs during the study period. Further analysis indicated the greatest degree of benefit would be derived from the adoption of the DASH Diet, which investigators purport could prevent an estimated 16,000 cardiovascular disease events among men and 11,000 such events among women.
“Members of many disadvantaged communities face barriers to healthy food and regular health care access,” Sims added. “This means they will not be able to benefit from a counseling from a doctor. Future research should investigate the big picture: social conditions granting people the time and resources to make healthy lifestyle choices. Only with this information can we develop policies for the prevention of heart disease, especially for vulnerable adults.”
This study, “Projected Impact Of Non-pharmacologic Management Of Stage 1 Hypertension Among Lower-risk U.S. Adults,” was published in Hypertension and presented at AHA Hypertension 22.