A Randomized Trial of a Low-Fat Diet Intervention on Blood Pressure and Hypertension: Tertiary Analysis of the WHI Dietary Modification Trial

Published on Aug 1, 2016in American Journal of Hypertension2.53
· DOI :10.1093/ajh/hpv196
Matthew A. Allison59
Estimated H-index: 59
(UCSD: University of California, San Diego),
Aaron K. Aragaki43
Estimated H-index: 43
(Fred Hutchinson Cancer Research Center)
+ 6 AuthorsLinda Van Horn72
Estimated H-index: 72
(NU: Northwestern University)
This post hoc analysis determined if the Women's Health Initiative (WHI) Diet Modification intervention (DM-I) resulted in a significantly different rate of incident hypertension (HTN), as well as longitudinal changes in blood pressure.Participants were 48,835 postmenopausal women aged 50-79 years who were randomly assigned to either the intervention or comparison group. HTN was defined as self-report of treated HTN collected semiannually or blood pressure ≥140/90mm Hg at one of the annual follow-up clinic visits.After a mean follow-up of 8.3 years, and among those who did not have HTN at baseline (n = 31,146), there were 16,174 (51.9%) HTN cases and those assigned to the intervention group had a 4% lower overall risk of developing incident HTN (hazard ratio (HR): 0.96, 95% confidence interval (CI): 0.93-0.99). Although the risk of HTN was lower in the DM-I group in the first few years, the HR became greater than 1 after year 5 (P-trend < 0.01). Similarly, randomization to the DM-I arm resulted in a small but significantly lower average systolic blood pressure (SBP) at 1 year of follow-up (-0.66mm Hg, 0.44-0.89) that increased over the following 8 years (0.16mm Hg/year, 0.11-0.21), such that any early benefit was eliminated by year 5 and a minimal deleterious effect emerged by year 7.Randomization to an intensive behavioral dietary modification program aimed at a lower total fat intake is not associated with sustained reductions in blood pressure or risk of HTN in postmenopausal women.url, unique identifier nct00000611.
  • References (23)
  • Citations (8)
#1Karen B. DeSalvo (HHS: United States Department of Health and Human Services)H-Index: 3
#2Richard Olson (HHS: United States Department of Health and Human Services)H-Index: 2
Last.Kellie O Casavale (HHS: United States Department of Health and Human Services)H-Index: 3
view all 3 authors...
#1Matthew A. Allison (UCSD: University of California, San Diego)H-Index: 59
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 43
Last.Jeffrey S. Berger (NYU: New York University)H-Index: 38
view all 7 authors...
#1Estefanía Toledo (University of Navarra)H-Index: 37
#2Frank B. Hu (Harvard University)H-Index: 202
Last.Miquel Fiol (UIB: University of the Balearic Islands)H-Index: 37
view all 20 authors...
#1Alan S. Go (CDC: Centers for Disease Control and Prevention)H-Index: 4
#2Dariush Mozaffarian (CDC: Centers for Disease Control and Prevention)H-Index: 113
Last.Caroline S. Fox (CDC: Centers for Disease Control and Prevention)H-Index: 124
view all 40 authors...
#1Barbara V. Howard (Georgetown University)H-Index: 114
#2J. David Curb (U.H.: University of Hawaii at Manoa)H-Index: 74
Last.Jacques E. Rossouw (NIH: National Institutes of Health)H-Index: 47
view all 13 authors...
#1Penny M. Kris-Etherton (PSU: Pennsylvania State University)H-Index: 88
#2Frank B. Hu (Brigham and Women's Hospital)H-Index: 202
Last.Joan Sabaté (LLU: Loma Linda University)H-Index: 45
view all 4 authors...
#1Barbara V. Howard (Memorial Hospital of South Bend)H-Index: 114
#2JoAnn E. Manson (Harvard University)H-Index: 232
Last.Lesley Tinker (Fred Hutchinson Cancer Research Center)H-Index: 45
view all 12 authors...
#1Cheryl L. Rock (KP: Kaiser Permanente)H-Index: 81
#2Ruth E. Patterson (Fred Hutchinson Cancer Research Center)H-Index: 65
Last.Judy Ockene (UMMS: University of Massachusetts Medical School)H-Index: 3
view all 7 authors...
Cited By8
#1Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 90
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 43
Last.Lewis E Kuller (University of Pittsburgh)
view all 14 authors...
#1Karen Rees (Warw.: University of Warwick)H-Index: 33
#2Andrea Takeda (UCL: University College London)H-Index: 4
Last.Saverio Stranges (UWO: University of Western Ontario)H-Index: 46
view all 9 authors...
#1A. K. M. Mofasser Hossain (LU: Lincoln University (Pennsylvania))H-Index: 1
#2Margaret A. Brennan (LU: Lincoln University (Pennsylvania))H-Index: 14
Last.Charles S. Brennan (LU: Lincoln University (Pennsylvania))H-Index: 35
view all 5 authors...
View next paperPhysician–Pharmacist Cooperation Program for Blood Pressure Control in Patients With Hypertension: A Randomized-Controlled Trial