The pathophysiology of hypertension is complex. Obesity plays an important role, as does renal aging, which affects sodium retention. The stiffness of large arteries increases with age, while compliance – pulsatile flow – diminishes. These vascular changes, which result from calcification and smooth muscle hyperplasia, are generally thought to be irreversible. Not so.
"If you’ve had a chance to feel those calcified arteries in an elderly person, you say, ‘Wow, these things are like metal pipes, how can that change?’ But functionally they can change," according to Dr. Sacks.
In the NHLBI-funded Exercise and Nutrition Interventions for Cardiovascular Health (ENCORE) study, investigators at Duke University showed that the DASH diet significantly improved central arterial stiffness as measured by pulse wave velocity, as well as left ventricular hypertrophy, baroreflex sensitivity, and both systolic and diastolic blood pressures. And randomization to the DASH diet plus a weight loss program resulted in larger improvements than diet alone (Arch. Intern. Med. 2010;170:126-35).
"Aging arteries can be rejuvenated by diet treatment. Youthful compliance of conduit arteries can be restored, at least partially. Improved endothelial function occurs in the microvasculature. And hypertension can be completely treated or prevented by optimal diets over a short period of time," Dr. Sacks concluded at the annual scientific sessions of the American Heart Association in Orlando.
He and Dr. Esposito reported having no financial conflicts.