Abstract P349: A Randomized Trial of a High Potassium Dietary Intervention to Lower Blood Pressure in Urban African Americans With Hypertension in the Primary Care Setting: The “Five Plus Nuts and Beans” Trial
Background: African Americans and persons with low income have greater exposure to poor food environments and are more likely to have deficiencies in micronutrients that lower blood pressure (BP).
Objective: We conducted a 2-arm randomized trial to test the hypothesis that delivery of nutritional advice to adopt a diet rich in potassium, tailored to availability of foods from a local supermarket, relevant to patients’ preferences, and combined with provision of targeted foods by a food delivery system, will reduce BP in urban African Americans with hypertension.
Methods: We recruited adults with controlled hypertension from an urban primary care clinic in Baltimore City, Maryland, and implemented the trial in partnership with a community supermarket and the Baltimore City Health Department. Participants in the DASH-Plus intervention group received 8 weeks of dietary advice and coach assistance with weekly online ordering of high potassium foods ($30/week) delivered by the supermarket to a neighborhood public library. Participants in the control group received a printed DASH diet brochure along with a debit account of equivalent value at the same supermarket. The primary outcome was BP.
Results: We randomized 123 participants and had 100% follow-up. At baseline, mean (SD) age was 58.6 (9.5) years, 71% were women, median household income was $20K-$30K/yr, BMI was 34.5 (8.2) kg/m2, and 28% had diabetes. At follow-up, compared to the control group, there was no effect on SBP and DBP, but the intervention group had significant increases in self-reported fruit and vegetable consumption, dietary intake of potassium, and in measured urine potassium excretion, along with a significant decrease in urine sodium excretion (see table).
Conclusion: Our intervention program in urban African Americans with controlled hypertension did not reduce BP, but improved dietary patterns. Limitations of this pragmatic trial approach included medication changes during the trial that affected BP and reliance on a single BP measurement at follow-up.
Author Disclosures: E.R. Miller: None. L.A. Cooper: None. K.A. Carson: None. N. Wang: None. L.J. Appel: None. D. Gayles: None. J. Charleston: None. K. White: None. A.T. Dalcin: None. M. Martin-Daniels: None. B. Bates-Hopkins: None. M. Albert: None. H. Yeh: None.
- © 2015 by American Heart Association, Inc.