The following is the summary of “Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial)” published in the January 2023 issue of Cardiovascular Disease by Jeong, et al.

Patients’ decisions to initiate pharmacologic therapy for the prevention of atherosclerotic cardiovascular disease (ASCVD) are heavily influenced by modern risk estimators like the American College of Cardiology/American Heart Association Pooled Cohort Equation, but there is insufficient evidence to inform expectations for 10-year ASCVD risk reduction from established lifestyle interventions. Their  analysis of the DASH (Dietary Approaches to Stop Hypertension) trial data allowed us to compare the 10-year ASCVD risk of participants who followed the DASH diet to those who followed a control diet or a fruits and vegetables (F/V) diet. Controlled feeding of a control diet, an F/V diet, or the DASH diet was administered to 459 persons aged 22 to 75 without CVD and not taking hypertension or diabetic mellitus drugs for 8 weeks as part of the DASH experiment. 

After the 8 weeks were up, we compared pre- and post-intervention blood pressure and cholesterol levels using the American College of Cardiology/American Heart Association Pooled Cohort Equation to estimate 10-year ASCVD risk. The DASH and F/V diets reduced the risk of ASCVD after a decade by 10.3% (95% CI 14.4 to 5.7) and 9.9% (95% CI 14.0 to 5.5), respectively, compared with the control diet. The reductions were larger in females and people of color. No significant change (-0.4%, 95% CI -6.9 to 6.5) was found between the DASH and F/V diets. 

There was a net relative advantage of 7.2% larger relative decrease from DASH compared with F/V, with a reduction in ASCVD related to the difference in systolic blood pressure alone ranging from -14.6% (-17.3 to -11.7) with the DASH diet and -7.9% (-10.9 to -4.8) with the F/V diet. In contrast to the F/V diet’s neutral effect of -1.9% (-5.0 to -1.2), the DASH diet’s effects on high-density lipoprotein increased 10-year ASCVD by 8.8% (-5.5 to 12.3). In conclusion, after 8 weeks on either the DASH or F/V diets, 10-year ASCVD risk scores were lowered by around 10% compared to the average American diet. These results have important implications for counseling patients about dietary choices and expectations for lowering 10-year ASCVD risk.

Source: sciencedirect.com/science/article/abs/pii/S0002914922011110