Blood Pressure Differences Associated with OMNIHEART-Like Diet Compared to a Typical American Diet

The DASH-Sodium trial demonstrated beneficial effects on blood pressure (BP) of the DASH dietwith lower sodium intake compared to typical American diet. The subsequent OMNIHEART trial reported additional BP benefits from replacing carbohydrate in the DASH dietwith either protein or monounsaturated fats. The primary aim of this study is to assess possible BP benefits of an OMNIHEART-like diet in free-living Americans using cross-sectional U.S. population data of the INTERMAP Study. INTERMAP data include four 24-h dietary recalls, two timed 24-h urine collections, eight BP readings for 2,195 individuals ages 40-59 from eight US INTERMAP population samples. Analyses are conducted using two approaches: 1. Regression of BP on a linear OMNIHEART nutrient score calculated for each individual, and 2. A Bayesian approach comparing estimated BP levels of an OMNIHEART-like nutrient profile with a typical American nutrient profile. After adjustment for potential confounders, an OMNIHEART score higher by one point was associated with systolic/diastolic BP differences of −1.0/−0.5 mmHg (both P<0.001). Mean systolic/diastolic BPs were 111.3/68.4 and 115.2/70.6 mmHg for Bayesian OMNIHEART and Control profiles respectively, after controlling for possible confounders, with BP differences of −3.9/−2.2 mmHg, Pr(difference ≤ 0) ≈ 0.98/0.96. Findings were comparable for men and women, for non-hypertensive participants, and with adjustment for antihypertensive treatment. Our findings from data on US population samples indicate broad generalizability of OMNIHEART results beyond the trial setting, and support recommendations for an OMNIHEART-style diet for prevention/control of population-wide adverse BP levels.