Plant-based Diet to Lower Blood Pressure?

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Hypertension is 1 of the major risk factors for heart disease and stroke, affecting approximately one-third of adults in developed countries. Treatment options include a low salt diet, medications, or even renal denervation surgery (ablation of the renal sympathetic nerves) when hypertension is resistant to less-intensive treatment. A meta-analysis of randomized, blinded, placebo-controlled studies investigating renal denervation for hypertension—including recent data from the RADIANCE-HTN TRIO study—evaluated changes in blood pressure (BP) with renal denervation surgery with or without concurrent antihypertensive agent use. The meta-analysis concluded that, regardless of antihypertensive use, renal denervation surgery resulted in significant decreases in 24-hour ambulatory and office systolic BP (mean difference: -3.61 mm Hg ambulatory, -5.86 mm Hg office) and diastolic BP (mean difference: -1.85 mm Hg ambulatory, -3.63 mm Hg office).

But renal denervation surgery would hardly be first-line treatment for most patients with hypertension. Is there another therapy to lower BP that has few adverse effects, is low cost, and has been shown to be effective? A group at the Park Nicollet Heart and Vascular Center (the "HeartBeet" Clinic) investigated if lifestyle changes, including promoting more plant and less animal product consumption, could lead to significant BP lowering in an 8-week pilot registry.

The clinic partnered with an employee wellness program to enroll 40 participants. Cholesterol, glucose, BP, and weight measurements were obtained before and after the pilot study. Participants took part in weekly, virtual, small-group coaching and large-group learning sessions; both were led by subject matter experts from Park Nicollet Heart and Vascular Center and focused on the 6 pillars of lifestyle medicine, including: adopting a plant-predominant eating pattern, optimizing physical activity, improving sleep, managing stress, forming and maintaining good personal relationships, and cessation of tobacco use and other unhealthy habits.

At the end of the study period, 100% of the participants showed improvements in 1 or more of the objective measures of cholesterol, BP, weight, or glucose. Further, 63% moved from the unhealthy range into the goal range for at least 1 of the objective measures of BP (<130/80 mm Hg), glucose (<100 mg/dL), and LDL cholesterol (<130 mg/dL). Looking at BP specifically, 70% improved their systolic BP with a mean difference in systolic BP of -5.28 mm Hg (P = .02, 95% CI: -9.81 to -0.75); mean difference in diastolic BP was -2.64 mm Hg (P = .2, 95% CI: -6.38 to 1.10). Dietary changes likely played a role: There was a 200% decrease in those reporting 15+ servings of animal products weekly, and a 96% increase in 15+ servings of plants weekly; 81% followed a whole food, plant-based diet most or all days of the week during the program.

In conclusion, cardiovascular risk factors, including elevated BP, showed improvements after an 8-week intervention focused on a plant-predominant diet, supported by the pillars of lifestyle medicine. Although a plant-based diet might seem extreme to decrease BP, consider it against the extremes of a lifetime of taking medications or of undergoing renal denervation surgery!

For further reading: The abstract was printed in the December journal of the American College of Lifestyle Medicine, and the "HeartBeet" Clinic was highlighted in the September issue of the American College of Cardiology magazine, Cardiology.

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Filed under: Preventive Medicine , Cardiometabolic

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