Cardiologists have been telling patients for years to lose weight.

The extent to which weight loss and exercise augment the cardiovascular benefits of the DASH diet was impressive in this study presented during the American College of Cardiology 2009 Scientific Sessions.

The Dietary Approaches to Stop Hypertension (DASH) diet is recommended to lower high blood pressure. It’s based on eating lots of fruits and vegetables, and is low in fat or non-fat dairy.

First, the details.

  • 144 unmedicated, sedentary, overweight or obese patients participated.
  • Their blood pressures were between 130 and 160 / 85 to 100 mmHg.
  • They were randomly assigned to 16 weeks of one of the following treatments.
    • Group 1: DASH diet + caloric restriction + exercise
    • Group 2: DASH diet alone
    • Group 3: Usual care
  • Exercise consisted of 30 minutes of treadmill walking 3 times per week.

And, the results for Groups 1, 2, and 3, respectively.

  • Systolic blood pressure change: -13, -5, -1 mmHg
  • Diastolic blood pressure change: -11, -9, -6 mmHg
  • Change in weight: -19, -0.6, +1.9 lbs
  • Those in the DASH + diet + exercise group (Group 1) also had more improvement in their cardiovascular disease risk profile as measured by blood sugar levels, baroreflex sensitivity, and left ventricular mass compared with the other subjects.
    • Baroreflex is a collection of nerves that help maintain the necessary blood pressure within the body.

The bottom line?
Let’s apply this information to the popular blood pressure lowering drugs, the angiotensin converting enzyme (ACE) inhibitors (ramipril [Altace], captopril [Capoten], enalapril [Vasotec], fosinopril [Monopril], lisinopril [Zestril], and quinapril [Accupril]).

According to a recent Cochrane review article, no ACE inhibitor appears to be any better or worse in terms of blood pressure lowering ability. The best estimate of the diastolic (second number) lowering is -8 to -5 mmHg.

Based on the results of this study, the DASH diet + caloric restriction + exercise lowers the diastolic blood pressure almost 50% more than can be achieved with an ACE inhibitor.

4/3/09 21:02 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.