DASH Diet and Sodium may together or independently Reduce ASCVD Risk among adults with high BP: Study

A new study published in the American Journal of Preventive Cardiology showed that the Dietary Approaches to Stop Hypertension (DASH) diet and salt reduction, both separately and in combination, decreased the risk of atherosclerotic cardiovascular disease (ASCVD) throughout a ten-year period.

National recommendations propose the Dietary Approaches to Stop Hypertension (DASH) diet to support cardiovascular health (CVH). DASH diets restrict saturated fat, cholesterol, and added sugars while emphasizing fruits, vegetables, whole grains, and low-fat dairy products. The projected 10-year risk of atherosclerotic cardiovascular disease (ASCVD) is reduced by the DASH diet. It is unclear how cutting salt in the diet will affect the risk of ASCVD. Thus, this study assessed how salt reduction, both by itself and in conjunction with the DASH diet, affects 10-year ASCVD risk scores.

Adults with high blood pressure (average systolic and diastolic blood pressures of 120 to 159 mm Hg and 80 to 95 mm Hg, respectively) were randomized to either the DASH diet or the standard American diet in the DASH-Sodium experiment. Three salt intake levels—low, medium, and high—were randomly assigned to each arm's participants.

The length of each phase was 30 days. At baseline and at the conclusion of each feeding period, 10-year ASCVD risk scores assessed by the pooled cohort equation were computed. Absolute and relative changes in 10-year ASCVD risk scores from baseline were the main outcomes of interest.

The 412 individuals (mean age 48 ± 10 years; 57% female, 57% Black) showed lower ASCVD risk scores in both dietary groups when salt intake was reduced. Low sodium consumption reduced the risk of ASCVD by 9.4% as compared to high salt intake.

The 10-year ASCVD changed by -5.3 percent as compared to a typical American diet when following the DASH diet. The combination of low sodium consumption and DASH reduced the risk of ASCVD by 14.1% when compared to a high sodium-control diet.

Overall, the DASH diet and salt restriction both markedly reduced the projected 10-year ASCVD risk in this high blood pressure cohort. When both therapies were used together, these effects were greater than when they were used separately. Furthermore, participants with baseline stage II hypertension, Black people, and women saw the greatest effects of salt decrease on 10-year ASCVD risk.

Source:

Knauss, H. M., Kovell, L. C., Miller, E. R., 3rd, Appel, L. J., Mukamal, K. J., Plante, T. B., & Juraschek, S. P. (2025). Dietary sodium reduction lowers 10-year atherosclerotic cardiovascular disease risk score: Results from the DASH-sodium trial. American Journal of Preventive Cardiology, 22(100980), 100980. https://doi.org/10.1016/j.ajpc.2025.100980