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Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association Lawrence J. Appel, Michael W. Brands, Stephen R. Daniels, Njeri Karanja, Patricia J. Elmer and Frank M. Sacks Hypertension 2006;47;296-308 DOI: 10.1161/01.HYP.0000202568.01167.B6
Hypertension is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TX 72514Copyright © 2006 American Heart Association. All rights reserved. Print ISSN: 0194-911X. Online ISSN: 1524-4563

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AHAScientific Statement
Dietary Approaches to Prevent and Treat Hypertension
A Scientific Statement From the American Heart Association
Lawrence J. Appel, MD, MPH; Michael W. Brands, PhD; Stephen R. Daniels, MD, PhD; Njeri Karanja, PhD; Patricia J. Elmer, PhD; Frank M. Sacks, MD
Abstract—A substantial body of evidence strongly supports the concept that multiple dietary factors affect blood pressure(BP). Well-established dietary modifications that lower BP are reduced salt intake, weight loss, and moderation of alcohol consumption (among those who drink). Over the past decade, increased potassium intake and consumption of dietary patterns based on the “DASH diet” have emerged as effective strategies that also lower BP. Of substantial public health relevance are findings related to blacksand older individuals. Specifically, blacks are especially sensitive to the BP-lowering effects of reduced salt intake, increased potassium intake, and the DASH diet. Furthermore, it is well documented that older individuals, a group at high risk for BP-related cardiovascular and renal diseases, can make and sustain dietary changes. The risk of cardiovascular disease increases progressivelythroughout the range of BP, beginning at 115/75 mm Hg. In view of the continuing epidemic of BP-related diseases and the increasing prevalence of hypertension, efforts to reduce BP in both nonhypertensive and hypertensive individuals are warranted. In nonhypertensive individuals, dietary changes can lower BP and prevent hypertension. In uncomplicated stage I hypertension (systolic BP of 140 to 159 mm Hgor diastolic BP of 90 to 99 mm Hg), dietary changes serve as initial treatment before drug therapy. In those hypertensive patients already on drug therapy, lifestyle modifications, particularly a reduced salt intake, can further lower BP. The current challenge to healthcare providers, researchers, government officials, and the general public is developing and implementing effective clinical andpublic health strategies that lead to sustained dietary changes among individuals and more broadly among whole populations. (Hypertension. 2006;47:296-308.) Key Words: AHA Scientific Statements blood pressure diet hypertension

levated blood pressure (BP) remains an extraordinarily common and important risk factor for cardiovascular and renal diseases, including stroke, coronary heart disease,heart failure, and kidney failure. According to the most recent NHANES survey (1999 to 2000), 27% of adult Americans have hypertension (systolic BP 140 mm Hg, diastolic BP 90 mm Hg, or use of antihypertensive medication), and another 31% have prehypertension (systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg, not on medication).1 Prehypertensive individuals have a high probability of...