Introduction
In observational studies, the association between the Dietary Approaches to Stop Hypertension
(DASH) diet and incident heart failure has been inconsistent. It was hypothesized
that higher DASH diet concordance has a protective effect on heart failure in a multi-ethnic
cohort.
Methods
The Multi-Ethnic Study of Atherosclerosis cohort includes men and women of multiple
ethnicities who were aged 45–84 years and free of clinical cardiovascular disease
at baseline. Participants were recruited between 2000 and 2002 from six U.S. communities
and followed for incident cardiovascular health events through 2015 for the purpose
of this data set. Diet was measured using food-frequency questionnaires. Cox proportional
hazards analysis was used to investigate the associations of the DASH diet concordance
with incident heart failure in 2017–2018.
Results
During a median 13 years of follow-up, 179 of 4,478 participants developed heart failure,
corresponding to a rate of 3.4 per 1,000 person years. Heart failure incidence rates
did not vary significantly by DASH quintile for the population as a whole. In participants
younger than 75 years, highest DASH concordance was associated with a lower risk of
incident heart failure compared with those in the lowest quintile (hazard ratio=0.4,
95% CI=0.2, 0.9 vs all participants hazard ratio=1.0, 95% CI=0.2, 0.9) after adjusting
for demographics, energy consumption, and known cardiovascular confounders.
Conclusions
This study supports the hypothesis that DASH is beneficial in heart failure prevention
within the individuals aged less than 75 years subgroup, an idea that to date was
substantiated only by much smaller studies or in less diverse patient populations.
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Article info
Publication history
Published online: April 17, 2019
Identification
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© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
