DASH in the treatment of hypertension

Konstantinos Tsioufis, MD, is a professor of cardiology at the University of Athens, Greece, and director of the hypertension unit of the First Cardiology Clinic in the Hippokration Hospital. He has served as president of the European Society of Hypertension (ESH).

Does the DASH diet play a role in the treatment of hypertension? Should it be recommended to patients?

Konstantinos Tsioufis, MD: First of all, I would say that lifestyle modification should be the first step in the treatment of hypertension. This is the recommendation of all the guidelines—the European Society of Hypertension guidelines, American guidelines... All the new editions of guidelines have lifestyle changes as the first step in the treatment of hypertension, and the diet is very, very important. But the main question is, which type of diet?

We have many, many different types. I’m from a Mediterranean country, from Greece. We are in favor of the Mediterranean diet, but we have to admit that also the Dietary Approaches to Stop Hypertension (DASH) have a clear beneficial effect on reducing high blood pressure. The difference between Mediterranean and DASH diets is mostly related to the amount/consumption of sodium. We know that sodium consumption has a main role in the pathogenesis of essential hypertension.

It is important for all patients to follow a certain diet like the Mediterranean or DASH diet, which is associated with a healthy pattern of lifestyle. At the end of the day, these diets will have a beneficial effect on blood pressure levels. However, the main issue is the low adherence of patients during the long-term follow-up of such diet. I would say we have to individualize it and try to select such a profile of diet for each one of the hypertensive individuals that suits very nicely their own needs, family, and social status in order to have long-term adherence to this diet.