A RANDOMIZED TRIAL OF TAILORED DIETARY ADVICE OR MINERAL SUPPLEMENTS TO LOWER BLO

Johns Hopkins University, Baltimore MD

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Abstract

Elevated blood pressure is an extraordinarily common and important risk factor for cardiovascular disease and stroke, particularly amongst African-Americans. Although pharmacological treatment of hypertension substantially lowers risk for cardiovascular complications, recommendations to adoption of the DASH diet (Dietary Approach to control Hypertension), are recognized as an integral part of medical management. However, there is a markedly lower availability of components of the DASH diet recommended foods such as fresh fruits and vegetables, skim milk, whole grained foods in predominantly black and lower income neighborhoods. The mechanism by which unhealthy dietary consumption patterns leads to hypertension is in part, a result of resultant deficiencies in potassium, magnesium and vitamin C: micronutrients with independent blood pressure lowering effects. Strategies to improve adherence to dietary recommendations and reverse micronutrient deficiencies in hypertensive African-American adults through tailored dietary advice or use of nutritional supplements are needed. In this application, we will test the hypotheses that whether dietitian-delivered recommendations for healthy food choices, tailored to availability of foods from local neighborhood stores relevant to individual patients, and the use of a mineral supplement (potassium, magnesium and vitamin C) will help in achieving dietary goals, improve blood pressure control, reduce insulin resistance, and lower uric acid in African Americans patients receiving regular care for treatment of hypertension. This study will be conducted as a randomized controlled 3-arm trial of 180 adults with hypertension recruited from the JHCP clinics in Baltimore Maryland. Participants randomized to dietitian-delivered DASH dietary advice, tailored to neighborhood food resources (D-T), printed DASH diet advice only group (D-0), or D-0 and a dietary supplement containing K, Mg, and Vitamin C (D-O-M). Participant in the D-T group will receive 3 one-on-one sessions with a dietitian. All participants will receive either the Mineral Supplements or placebo. The primary outcome is change in 24-hour systolic blood pressure.