A large-scale study of more than 83,000 people has identified the most effective diet for managing high blood pressure, according to findings published in The Journal of Nutrition.
Researchers analyzed data from 83,248 UK Biobank participants who had high blood pressure but no prior heart disease. Each person’s diet was scored against five established healthy eating patterns: the Dietary Approaches to Stop Hypertension (DASH) diet, the AHEI-2010, the Mediterranean diet (AMED), a plant-based diet index (hPDI), and an anti-inflammatory pattern (EDIP).
All of these diets emphasize fruits, vegetables, whole grains, low-fat dairy, lean proteins such as fish and poultry, nuts, and legumes. They also limit sodium, red meat, added sugars, and saturated fat. Researchers tracked heart disease outcomes and overall death rates over time.
The DASH diet outperformed every other diet for reducing heart disease risk and improving longevity. Compared to people who followed DASH the least closely, those who followed it most closely had a 15% lower risk of heart disease and a 22% lower risk of dying from any cause. Across all five dietary patterns, the reduction in death from any cause ranged from 15% to 22%, with DASH showing the strongest link.
In this specific group of people with high blood pressure, the Mediterranean diet and a plant-based diet did not appear to be associated with heart disease risk.
Why the Mediterranean diet did not stand out
The Mediterranean diet has a strong record for heart health in the general population, and that evidence remains valid. However, this study focused on people with untreated or uncontrolled high blood pressure, a group with specific dietary needs.
The DASH diet was designed around nutrients that directly affect blood pressure, including high levels of potassium, calcium, and magnesium, with a strong focus on keeping sodium low. The Mediterranean diet, while rich in healthy fats and anti-inflammatory foods, does not place the same emphasis on those specific nutrients or sodium restriction.
A 2022 review found that combining a low-sodium diet with DASH produced greater blood pressure reductions than either approach alone.
The anti-inflammatory connection
The anti-inflammatory dietary pattern (EDIP), which measures how pro- or anti-inflammatory a person’s overall diet is, was one of two patterns alongside DASH to show significant links to both heart disease risk and death rates in this study. Diets that score well on the EDIP are rich in leafy greens, fruits, whole grains, and omega-3-rich foods, while limiting processed meats, refined carbohydrates, and trans fats.
Both DASH and EDIP patterns prioritize whole, nutrient-dense foods and limit processed, high-sodium options. The fact that both showed significant results suggests that reducing dietary inflammation may be part of how DASH lowers heart disease risk, not just through blood pressure effects alone.
How to build a DASH-style plate
The DASH diet is not a strict protocol but a flexible framework. It recommends eating more fruits and vegetables, aiming for 8 to 10 servings a day as main sources of potassium, magnesium, and fiber. It also encourages whole grains such as whole wheat bread, brown rice, oats, and quinoa instead of refined grains. Low-fat dairy, two to three servings a day, provides calcium and potassium without a lot of saturated fat. Lean proteins include fish, poultry, beans, and lentils, with red meat limited to a few times a week. Nuts and seeds are recommended in small amounts most days for healthy fats and magnesium.
The diet advises cutting back on sodium, with a standard target of 2,300 milligrams per day and a lower-sodium version targeting 1,500 milligrams for even greater blood pressure benefits. Added sugars should be limited to five or fewer servings per week. Saturated and trans fats from full-fat dairy, fatty meats, and processed snacks should be reduced. Red and processed meats are linked to higher inflammation and heart disease risk.
The analysis found that all five dietary patterns were associated with lower death rates, and the AHEI-2010 also showed a significant link to reduced heart disease risk. For people managing blood pressure, DASH has the most targeted, evidence-backed support of any dietary pattern studied.
