DASH-patterned groceries and effects on blood pressure in adults treated for hypertension: the GoFreshRx randomized...

Although a Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to lower blood pressure (BP) in Black adults, this intervention has not been tested in individuals who were being actively treated for hypertension. In this study, we conducted a randomized clinical trial (GoFreshRx) to test whether local groceries ordered with the assistance of a dietitian to align with the DASH diet might lower BP among Black adult residents of Boston communities with few grocery stores who were being actively treated for hypertension. Individuals whose systolic blood pressure (SBP) was 120 mmHg to <150 mmHg despite active hypertension treatment were randomized either to 12 weeks of weekly home-delivered DASH groceries with dietitian counseling or to receiving three US$500 stipends every 4 weeks. The primary outcome was research clinic-measured SBP measured at 3 months. Secondary outcomes were diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-c) levels. Maintenance of health effects was assessed at 3 months after the intervention. Of 176 participants (mean age 60.1 (s.d., 11.5) years; 80.7% female), 173 were available for SBP measurement at 3 months. Mean (s.d.) baseline SBP/DBP was 130.5 (7.0)/77.8 (8.9) mmHg. At 3 months, SBP changed by -7.0 mmHg in the DASH groceries group and by -2.0 mmHg in the self-directed group (intergroup difference: -5.0 mmHg; 95% confidence interval: -8.0 to -1.9; P = 0.002). Moreover, compared to the self-directed group, 3 months of DASH groceries changed DBP by -1.8 mmHg (-3.6 to -0.1) and LDL-c by -7.0 mg dl^-1 (-13.6 to -0.5). In prespecified analyses, the beneficial effects of DASH grocery delivery on SBP and DBP were partially maintained 3 months after the intervention had concluded. Nutrient-targeted grocery ordering appears to be a useful strategy to improve longer-term cardiometabolic health. ClinicalTrials.gov registration: NCT05393232 .