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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. Allison68
Estimated H-index: 68
(UCSD: University of California, San Diego),
Aaron K. Aragaki40
Estimated H-index: 40
(Fred Hutchinson Cancer Research Center)
+ 6 AuthorsLinda Van Horn78
Estimated H-index: 78
(NU: Northwestern University)
Abstract
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 http://www.clinicaltrials.gov, unique identifier nct00000611.
  • References (22)
  • Citations (9)
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References22
Newest
#1Karen B. DeSalvo (HHS: United States Department of Health and Human Services)H-Index: 25
#2Richard D. 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: 4
view all 3 authors...
This Viewpoint summarizes the updated recommendations of the US Department of Health and Human Services’ recently released 2015-2020 Dietary Guidelines for Americans.
594 CitationsSource
#1Matthew A. Allison (UCSD: University of California, San Diego)H-Index: 68
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 40
Last. Jeffrey S. Berger (NYU: New York University)H-Index: 39
view all 7 authors...
Background and Purpose—Because the diagnosis and treatment of carotid artery disease may reduce the rate of stroke, the aim of this study was to determine whether a diet intervention was associated with incident carotid artery disease. Methods—Participants were 48 835 postmenopausal women aged 50 to 79 years who were randomly assigned to either the intervention or comparison group in the Women’s Health Initiative Diet Modification Trial. Incident carotid artery disease was defined as an overnigh...
3 CitationsSource
#1Estefanía Toledo (University of Navarra)H-Index: 39
#2Frank B. Hu (Harvard University)H-Index: 205
Last. Miguel A. Martínez-González (University of Navarra)H-Index: 87
view all 20 authors...
Background Hypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern.
137 CitationsSource
cording to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval (CI), 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, ver -
2,681 CitationsSource
#1Alan S. Go (CDC: Centers for Disease Control and Prevention)H-Index: 12
#2Dariush Mozaffarian (CDC: Centers for Disease Control and Prevention)H-Index: 120
Last. Melanie B. Turner (CDC: Centers for Disease Control and Prevention)H-Index: 17
view all 40 authors...
4,063 CitationsSource
#1Barbara V. Howard (Georgetown University)H-Index: 115
#2J. David Curb (U.H.: University of Hawaii at Manoa)H-Index: 58
Last. Linda Van Horn (NU: Northwestern University)H-Index: 78
view all 13 authors...
Background: The Women's Health Initiative Dietary Modification Trial tested the effects on chronic disease of a dietary pattern lower in fat and higher in vegetables, fruit, and grains. Objective: The objective was to evaluate the effects of dietary carbohydrate changes on lipids and lipoprotein composition. Design: Postmenopausal women were randomly assigned to an intervention or a comparison group for a mean of 8.1 y. Lipoprotein analyses and subclasses were based on subsamples of 2730 and 209...
39 CitationsSource
#1Penny M. Kris-Etherton (PSU: Pennsylvania State University)H-Index: 89
#2Frank B. Hu (Brigham and Women's Hospital)H-Index: 205
Last. Joan Sabaté (LLU: Loma Linda University)H-Index: 46
view all 4 authors...
Epidemiologic and clinical trial evidence has demonstrated consistent benefits of nut and peanut consumption on coronary heart disease (CHD) risk and associated risk factors. The epidemiologic studies have reported various endpoints, including fatal CHD, total CHD death, total CHD, and nonfatal myocardial infarct. A pooled analysis of 4 U.S. epidemiologic studies showed that subjects in the highest intake group for nut consumption had an ∼35% reduced risk of CHD incidence. The reduction in total...
262 CitationsSource
#1Barbara V. Howard (HU: Howard University)H-Index: 115
#2Linda Van Horn (NU: Northwestern University)H-Index: 78
Last. Jane Morley Kotchen (MCW: Medical College of Wisconsin)H-Index: 39
view all 47 authors...
ContextMultiple epidemiologic studies and some trials have linked diet with cardiovascular disease (CVD) prevention, but long-term intervention data are needed.ObjectiveTo test the hypothesis that a dietary intervention, intended to be low in fat and high in vegetables, fruits, and grains to reduce cancer, would reduce CVD risk.Design, Setting, and ParticipantsRandomized controlled trial of 48 835 postmenopausal women aged 50 to 79 years, of diverse backgrounds and ethnicities, who participated ...
846 CitationsSource
#1Barbara V. Howard (Memorial Hospital of South Bend)H-Index: 115
#2JoAnn E. Manson (Harvard University)H-Index: 235
Last. Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 90
view all 12 authors...
ContextObesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets.ObjectivesTo report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relat...
340 CitationsSource
#1Rebecca D. JacksonH-Index: 83
#2Andrea Z. LaCroixH-Index: 102
Last. Joan McGowanH-Index: 14
view all 4 authors...
122 CitationsSource
Cited By9
Newest
#1Linda Van Horn (NU: Northwestern University)H-Index: 78
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 40
Last. Mara Z. Vitolin (Wake Forest University)H-Index: 1
view all 12 authors...
Background: Women without cardiovascular disease (CVD) or hypertension at baseline assigned to intervention in the Women's Health Initiative Dietary Modification (DM) trial experienced 30% lower risk of coronary heart disease (CHD), whereas results in women with hypertension or prior CVD could have been confounded by postrandomization use of statins. Objectives: Intervention participants reported various self-selected changes to achieve the 20% total fat goals. Reviewed are intervention compared...
Source
#1Rowan T. Chlebowski (UCLA: University of California, Los Angeles)H-Index: 78
#2S. Rapp (Wake Forest University)H-Index: 3
Last. Ross L. Prentice (Wake Forest University)
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Abstract Background Meta-analyses of observational studies associate adherence to several dietary patterns with cognitive health. However, limited evidence from full scale, randomized controlled trials precludes causal inference regarding dietary effects on cognitive function. Methods The Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, in 48,835 postmenopausal women, included a subset of 1,606 WHI Memory Study (WHIMS) participants >= 65 years old, to assess low-fat di...
Source
#1Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 90
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 40
Last. Jacques E. RossouwH-Index: 45
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Background The preferred macronutrient dietary composition, and the health consequences of dietary fat reduction specifically, have been debated for decades. Here we provide a comprehensive overview of long-term health outcomes in the Women's Health Initiative Dietary Modification (DM) trial.
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Purpose of Review Do dietary fats lower blood pressure? This review covers total fats, individual fatty acids and foods that provide specific fats.
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#1Sarah O'Connor (Laval University)H-Index: 2
#2Iwona Rudkowska (Laval University)H-Index: 20
Abstract Dietary fatty acids are present in a wide variety of foods and appear in different forms and lengths. The different fatty acids are known to have various effects on metabolic health. The metabolic syndrome (MetS) is a constellation of risk factors of chronic diseases. The etiology of the MetS is represented by a complex interplay of genetic and environmental factors. Dietary fatty acids can be important contributors of the evolution or in prevention of the MetS; however, great interindi...
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#1Emelia J. BenjaminH-Index: 154
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Each chapter listed in the Table of Contents (see next page) is a hyperlink to that chapter. The reader clicks the chapter name to access that chapter. Each chapter listed here is a hyperlink. Click on the chapter name to be taken to that chapter. Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together in a single document the most up-to-date statistics r...
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A diet with high glycaemic index, which causes rapid spikes in blood sugar level, can lead to disorders such as significantly increased risk for type 2 diabetes, cardiovascular disease and obesity. These conditions are also linked to the progression of cognitive decline and neurodegenerative diseases including Alzheimer’s disease. Blackcurrant powder (BC) is a rich source of dietary fibre and bioactive compounds. Wholemeal wheat, barley and oat flours contain high amount of fibre. In this study,...
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Pomegranate extract decreases oxidative stress and alleviates mitochondrial impairment by activating AMPK-Nrf2 in hypothalamic paraventricular nucleus of spontaneously hypertensive rats
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