Article Impact Level: HIGH Data Quality: STRONG Summary of The American Journal of Medicine, S0002934324003577. https://doi.org/10.1016/j.amjmed.2024.06.006 Dr. Nimrit Goraya et al.
Points
- In a randomized clinical trial with 153 hypertensive patients with macroalbuminuria, researchers evaluated the effects of dietary interventions on chronic kidney disease (CKD) progression and cardiovascular disease (CVD) risk over five years.
- Participants were divided into three groups: high fruits and vegetables diet, oral sodium bicarbonate (NaHCO3), and Usual Care.
- Patients in the fruits and vegetables and NaHCO3 groups had slower CKD progression compared to the Usual Care group, with annual declines in glomerular filtration rates of −1.08 and −1.17 mL/min/1.73m², respectively, versus −1.94 mL/min/1.73m² in the Usual Care group (P’s < .001).
- Despite using lower pharmacological treatments, the fruits and vegetables group also showed more significant reductions in systolic blood pressure and improvements in CVD risk indices compared to the NaHCO3 and Usual Care groups.
- The study highlights the effectiveness of a diet rich in fruits and vegetables in managing hypertension, slowing CKD progression, and reducing CVD risk, supporting dietary interventions as a complementary approach to traditional pharmacological treatments.
Summary
In a randomized clinical trial involving 153 hypertensive patients with macroalbuminuria, researchers assessed the effectiveness of dietary interventions on chronic kidney disease (CKD) progression and cardiovascular disease (CVD) risk over five years. Patients were assigned to one of three groups: receiving a diet high in fruits and vegetables, oral sodium bicarbonate (NaHCO3), or Usual Care. The study aimed to determine whether these dietary approaches, known for their low acid content and association with reduced CKD and CVD risks, could be effective in managing hypertension and slowing the progression of kidney disease.
The results indicated significant differences in CKD progression rates among the groups. Patients in the fruits and vegetables group and the NaHCO3 group experienced slower CKD progression compared to those in the Usual Care group, with mean (SE) annual declines in glomerular filtration rate of −1.08 (0.06) and −1.17 (0.07) mL/min/1.73m², respectively, versus −1.94 (0.11) mL/min/1.73m² in the Usual Care group (P’s < .001). Moreover, the study found that the systolic blood pressure reductions and improvements in CVD risk indices were more pronounced in the fruits and vegetables group than in either the NaHCO3 or Usual Care groups. Remarkably, these cardiovascular benefits were achieved despite using lower pharmacological interventions for CKD and CVD doses.
The findings support the incorporation of diets rich in fruits and vegetables as a foundational element in the treatment of hypertension, with benefits extending beyond blood pressure control to include significant reductions in the progression of CKD and overall CVD risk. This study underscores the potential of dietary interventions as a complementary approach to pharmacological treatments, offering a holistic strategy to manage hypertension and its associated long-term health risks.
Link to the article: https://www.amjmed.com/article/S0002-9343(24)00357-7/fulltext
References Goraya, N., Madias, N. E., Simoni, J., Kahlon, M., Aksan, N., & Wesson, D. E. (2024). Kidney and Cardiovascular Protection Using Dietary Acid Reduction in Primary Hypertension: A Five-Year, Interventional, Randomized, Control Trial. The American Journal of Medicine, S0002934324003577. https://doi.org/10.1016/j.amjmed.2024.06.006
