Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults
Résumé
C hanging demographics is creating a larger population of people aged 60 year or over: the median age in Europe is the highest in the world, and the proportion of people aged 65 years and older is forecast to increase from 14% in 2010 to 28% in 2060. 1 Even in the absence of clinical hypertension the aging process is associated with cardiovascular changes that impair arterial function leading to an increased risk of cardio-vascular disease in this population group. 2 Diet is a tractable modifier of vascular health and blood pressure (BP), and it has been shown that targeting the whole diet has synergistic and cumulative effects on BP over individual foods and nutrients. 3 The most well-established dietary interventions for the reduction in BP are the Dietary Approaches to Stop Hypertension (DASH) diet 4 and the Mediterranean diet. 5 Both of these dietary patterns have been shown to reduce BP in randomized controlled trials. 4,6 Adherence to the DASH diet for 8 weeks reduced systolic (SBP) and diastolic (DBP) BP by 5.5 and 3.0 mm Hg, respectively , compared with a control diet. 4 The Prevención con Dieta Mediterránea trial in patients at high cardiovascular Abstract-We aimed to determine the effect of a Mediterranean-style diet, tailored to meet dietary recommendations for older adults, on blood pressure and arterial stiffness. In 12 months, randomized controlled trial (NU-AGE [New Dietary Strategies Addressing the Specific Needs of Elderly Population for Healthy Aging in Europe]), blood pressure was measured in 1294 healthy participants, aged 65 to 79 years, recruited from 5 European centers, and arterial stiffness in a subset of 225 participants. The intervention group received individually tailored standardized dietary advice and commercially available foods to increase adherence to a Mediterranean diet. The control group continued on their habitual diet and was provided with current national dietary guidance. In the 1142 participants who completed the trial (88.2%), after 1 year the intervention resulted in a significant reduction in systolic blood pressure (−5.5 mm Hg; 95% CI, −10.7 to −0.4; P=0.03), which was evident in males (−9.2 mm Hg, P=0.02) but not females (−3.1 mm Hg, P=0.37). The −1.7 mm Hg (95% CI, −4.3 to 0.9) decrease in diastolic pressure after intervention did not reach statistical significance. In a subset (n=225), augmentation index, a measure of arterial stiffness, was improved following intervention (−12.4; 95% CI, −24.4 to −0.5; P=0.04) with no change in pulse wave velocity. The intervention also resulted in an increase in 24-hour urinary potassium (8.8 mmol/L; 95% CI, 0.7-16.9; P=0.03) and in male participants (52%) a reduction in pulse pressure (−6.1 mm Hg; 95% CI, −12.0 to −0.2; P=0.04) and 24-hour urinary sodium (−27.1 mmol/L; 95% CI, −53.3 to −1.0; P=0.04). In conclusion, a Mediterranean-style diet is effective in improving cardiovascular health with clinically relevant reductions in blood pressure and arterial stiffness. Clinical Trial Registration-URL: http://www.clinicialtrials.gov. Unique identifier: NCT01754012. (Hypertension. 2019;73:578-586.
Domaines
Sciences de l'Homme et Société
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