Factors affecting blood pressure responses to diet: The vanguard study

Lawrence M. Resnick, Suzanne Oparil, Alan Chait, R. Brian Haynes, Penny Kris-Etherton, Judith S. Stern, Sharon Clark, Scott Holcomb, Daniel C. Hatton, Jill A. Metz, Margaret McMahon, F. Xavier Pi-Sunyer, David A. McCarron

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

To study physiologic factors affecting the blood pressure (BP) response to nonpharmacologic maneuvers, fasting blood glucose, insulin, lipid and mineral levels, urinary mineral excretion, and the calcium regulating hormones parathyroid hormone (PTH) and 1,25 dihydroxyvitamin D (1,25 (OH)2D) were measured in 71 unmedicated hypertensive (26 hypertensive only [HT], 45 hypertensive hyperlipidemic [HTHL]), and 87 normotensive hyperlipidemic (NTHL) control subjects before and during a 10-week multicenter, randomized controlled trial comparing a prepared meal plan (CCNW) with a self-selected diet (SSD) based on nutritionist counseling. Blood pressure fell to a greater extent in hypertensive versus normotensive subjects (-8 ± 1/-5 ± 1 υ -2 ± 1/-2 ±1 mm Hg, P < .0001/P < .0001), and on CCNW versus SSD diets (Δ systolic BP [SBP]/Δ diastolic BP [DBP], P = .033/P = .002). Diet-induced weight change was the strongest correlate of changes in BP (SBP: r = 0.360, P < .0001; DBP: r = 0.414, P < .0001), which, on multivariate analysis for ΔSBP, could partly be accounted for by diet-induced changes in fasting glucose (r = 0.215, P = .009) and cholesterol (r = 0.219, P = .006) levels. Independently of weight, diet-induced changes in SBP also were significantly related to concomitant changes in urinary excretion of potassium (r = -0.285, P = .001), magnesium (r = -0.254, P = .003), and calcium relative to sodium (r = -0.200, P = .021), but not to sodium per se; and to changes in serum potassium (r = -0.249, P = .002), phosphorus (r = -0.279, P = .001), PTH (r = 0.288, P = .0006), and 1,25 D (r = 0.202, P = .017). We conclude that the ability of diet to lower BP successfully may result from the additive contributions of multiple components. Independently of weight loss and the associated changes in circulating glucose and cholesterol, BP is influenced by the increasing provision of minerals such as potassium, magnesium, and calcium, perhaps by virtue of their suppressive effects on circulating vasoactive calcium regulating hormones. (C) 2000 American Journal of Hypertension, Ltd.

Original languageEnglish (US)
Pages (from-to)956-965
Number of pages10
JournalAmerican journal of hypertension
Volume13
Issue number9
DOIs
StatePublished - 2000

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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