Researchers have analyzed data from more than 83,000 people with high blood pressure and found that one diet stands out above others for reducing heart disease risk and extending lifespan.
The study, published in The Journal of Nutrition, compared five well-known dietary patterns in people with high blood pressure. All participants had high blood pressure but no prior heart disease. Each person’s diet was scored against the Dietary Approaches to Stop Hypertension (DASH) diet, the AHEI-2010, the Mediterranean diet (AMED), a plant-based diet index (hPDI), and an anti-inflammatory pattern (EDIP).
All of these diets share a focus on fruits, vegetables, whole grains, low-fat dairy, lean proteins such as fish and poultry, nuts, and legumes. They also limit sodium, red meat, added sugars, and saturated fat. Researchers tracked heart disease outcomes and overall death rates over time.
DASH outperformed other diets
People who followed the DASH diet most closely had a 15% lower risk of heart disease and a 22% lower risk of dying from any cause, compared to those who followed it the least. These results were the strongest among all five dietary patterns studied.
Across all five diets, the reduction in risk of death from any cause ranged from 15% to 22%. However, the Mediterranean diet and the plant-based diet did not show a clear link to reduced heart disease risk in this specific group.
Why the Mediterranean diet did not stand out
The Mediterranean diet has strong evidence for heart health in the general population. But this study focused on people with untreated or uncontrolled high blood pressure. The DASH diet was designed around nutrients that directly affect blood pressure, such as high levels of potassium, calcium, and magnesium, while keeping sodium low. The Mediterranean diet, while rich in healthy fats and anti-inflammatory foods, does not place the same emphasis on these specific nutrients or sodium restriction.
A 2022 review found that combining a low-sodium diet with DASH produced greater blood pressure reductions than either approach alone.
The anti-inflammatory connection
The anti-inflammatory diet pattern (EDIP) was one of two diets, alongside DASH, to show strong links to both heart disease risk and death rates. Diets that score well on the EDIP are rich in leafy greens, fruits, whole grains, and omega-3-rich foods, while limiting processed meats, refined carbs, and trans fats. Both DASH and EDIP patterns prioritize whole, nutrient-dense foods and limit processed, high-sodium options. This suggests that reducing inflammation may be part of how DASH lowers heart disease risk, not just through blood pressure effects alone.
Building a DASH-style plate
The DASH diet is a flexible framework, not a strict protocol. It recommends eating more fruits and vegetables, aiming for 8 to 10 servings a day. Whole grains such as whole wheat bread, brown rice, oats, and quinoa replace refined grains. Low-fat dairy provides calcium and potassium without saturated fat. Lean proteins include fish, poultry, beans, and lentils, with red meat limited to a few times a week. Nuts and seeds offer healthy fats and magnesium.
The diet calls for cutting back on sodium, with a standard target of 2,300 mg per day and a lower-sodium version targeting 1,500 mg for greater blood pressure benefits. Added sugars should be limited to five or fewer servings per week. Saturated and trans fats from full-fat dairy, fatty meats, and processed snacks are reduced. Red and processed meats are limited because they are linked to higher inflammation and heart disease risk.
The analysis of more than 83,000 people with high blood pressure found that the DASH diet was the strongest performer across all five dietary patterns studied, reducing both heart disease risk and overall mortality. All five patterns were associated with lower mortality, and the AHEI-2010 also showed a significant link to reduced heart disease risk. For people managing blood pressure, DASH has the most targeted, evidence-backed support of any dietary pattern in this study.
