Increasing fruit and vegetable intake to reduce dietary acid can lower blood pressure and enhance kidney and heart health in hypertensive patients, Study Finds

In a recent study published in The American Journal of Medicine Doctors recommend making fruits and vegetables a foundational part of the treatment of patients with hypertension. Diets high in fruits and vegetables are found to lower blood pressure, reduce cardiovascular risk, and improve kidney health due to their base-producing effects.

Despite ongoing efforts to improve hypertension treatment and reduce its adverse outcomes with pharmacological strategies, hypertension-related chronic kidney disease and its cardiovascular mortality are increasing. Heart disease is the number one reason that patients with chronic kidney disease die.

The Dietary Approaches to Stop Hypertension (DASH) diet that is rich in fruits and vegetables reduces blood pressure and is the recommended first-line treatment for primary hypertension. Nevertheless, this diet is under-prescribed, and when prescribed is under-implemented despite supportive epidemiological data. The DASH diet and others generally high in fruits and vegetables are associated with lower blood pressure, lower risk for and progression of chronic kidney disease, lower cardiovascular disease risk indicators, and lower cardiovascular disease mortality.

To test this hypothesis, a study was designed in which participants with hypertension, but not diabetes, and very high levels of urine albumin excretion (macroalbuminuria) were selected. Patients with macroalbuminuria have chronic kidney disease, a high risk for the worsening of their kidney disease with time, and a high risk of subsequently developing cardiovascular diseases. In a randomized control trial over five years, investigators divided the cohort of 153 patients with hypertension into three groups:

1. Study participants add 2-4 cups of base-producing fruits and vegetables in addition to their usual daily food intake

2. Study participants prescribed NaHCO3 (acid-reducing sodium bicarbonate, which is common baking soda) tablets in two daily doses of 4-5 650 mg tablets

3. Study participants receiving standard medical care from primary care clinicians

The results of the study show that both fruits and vegetables and NaHCO3 improved kidney health, but only fruits and vegetables, and not NaHCO3, reduced blood pressure and improved indices of cardiovascular disease risk.

References: Joint National Commission on detection, evaluation, and treatment of high blood pressure. The fifth report of the Joint National Commission on detection, evaluation, and treatment of high blood pressure (JNC V). Arch Int Med 1993;153, 154-186.