Abstract 023: Effects Of Sodium Reduction And The Dash Diet On Subclinical Cardiac Damage: Results From The Dash-Sodium Trial

Background: We recently documented that the DASH diet has beneficial effects on cardiac biomarkers. The effects of sodium reduction, alone or combined with the DASH diet, are unknown. Objective: To determine the effects of sodium reduction and the DASH diet, alone or combined, on biomarkers of cardiac injury, strain, and inflammation. Methods: DASH-Sodium was a controlled, feeding study in adults with pre- or stage 1 hypertension, who were randomly assigned to the DASH diet or a control diet. On their assigned diet, participants consumed each of three sodium levels for 4 weeks. Body weight was kept constant. The three sodium levels were low (50 mmol/d), medium (100 mmol/d), and high (150 mmol/d). Outcomes were 3 biomarkers representing distinct pathways of cardiac damage: high-sensitivity cardiac troponin I (hs-cTnI, measure of cardiac injury), N-terminal b-type pro natriuretic peptide (NT-proBNP, measure of strain), and high-sensitivity C-reactive protein (hs-CRP, measure of inflammation), collected at baseline and at the end of each feeding period. Results: Of the original 412 participants, mean age was 48 yr; 56% were women, and 56% black. Mean baseline SBP/DBP was 135/86 mm Hg. Lower sodium reduced NT-proBNP independent of diet (overall %-difference of -19%; 95% CI: -24, -14), but not hs-cTnI or hs-CRP ( Figure ). In contrast, DASH (vs control) reduced hs-cTnI by 18% (95% CI: -27, -7) and hs-CRP by 13% (95% CI: -24, -1), but not NT-proBNP. Combining both sodium reduction with DASH reduced hs-cTnI by 20% (95% CI: -31%, -7%), NT-proBNP by 23% (95% CI: -32%, -12%), and hs-CRP by 7% (95% CI: -22%, 9%) compared to the high sodium, control diet. Conclusions: Combining sodium reduction with a DASH dietary pattern represents an efficacious strategy to lower three distinct mechanisms of subclinical cardiac damage: injury, strain, and to a lesser extent inflammation.