DASH and Mediterranean diets reduce blood pressure
Näytönastekatsaukset
21.9.2026
Level of evidence: B
The DASH diet probably lowers blood pressure in adults with elevated blood pressure or hypertension, with average reductions of approximately 3–9 mmHg in systolic blood pressure and 2.5–4.5 mmHg in diastolic blood pressure. Mediterranean type diets probably lower blood pressure as well, but with smaller average effects.
Comment: No specific harms were quantified in these reviews; dietary pattern interventions are generally considered low risk for individuals, but feasibility and adherence may vary, and some modified diets may require individualized guidance.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias «Additional comments for included studies»2 |
|---|---|---|---|---|---|
| SR=systematic review; MA=meta-analysis | |||||
| «Filippou CD, Tsioufis CP, Thomopoulos CG, ym. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Ana»1 | SR, MA | Adults (≥18 years), hypertensive or non-hypertensive blood pressure levels with or without comorbidities, such as obesity, metabolic syndrome, or type 2 diabetes. Countries not specified. | RCTs. DASH dietary (Dietary Approaches to Stop Hypertension). Some trials applied DASH alone, while others combined DASH with additional lifestyle interventions (e.g. sodium restriction, energy restriction/weight loss, or physical activity). Comparison: usual care | Systolic and diastolic blood pressure | Low |
| «Fu J, Liu Y, Zhang L, ym. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020;9(19):e016804 »2 | SR, MA | Adults (≥18 years) with prehypertension or hypertension. Europe, United States, Asia, Africa; DASH RCTs United States, China. | RCTs. Nonpharmacologic (lifestyle) interventions ≥4 week including dietary (e.g., DASH, salt restriction, low-sodium/high-potassium salt, low-calorie diet), physical exercise, stress-reduction approaches, alcohol restriction and weight loss, combined interventions, and comprehensive lifestyle modification. Comparison: usual care | Systolic and diastolic blood pressure | Low |
| «Cowell OR, Mistry N, Deighton K, ym. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 202»3 | SR, MA | Adults (≥18 years) with or without comorbidities, such as obesity, metabolic syndrome, or type 2 diabetes were included. Participants were not excluded based on health status or smoking history. Countries not specified. | RCTs and observational studies. Intervention: Mediterranean diet (MedDiet), including standard and modified versions. Comparison: a control diet. | Systolic and diastolic blood pressure | Moderate |
| «Filippou CD, Thomopoulos CG, Kouremeti MM, ym. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled t»4 | SR, MA | Adults (hypertensive and non-hypertensive) with or without comorbidities (e.g., obesity, type 2 diabetes, hypercholesterolemia, metabolic syndrome, established cardiovascular disease). Countries not specified. | RCTs Intervention: Mediterranean diet (MedDiet), alone or with other lifestyle interventions. Comparison: Usual diet | Systolic and diastolic blood pressure | Low |
| Reference | Comments |
|---|---|
| «Cowell OR, Mistry N, Deighton K, ym. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 202»3 | Due to variability in study quality and risk of bias across included studies. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval; N/A=not applicable; SBP=systolic blood pressure; MD=mean difference; DPB=diastolic blood pressure; WMD= weighted mean difference; CrI=credible interval; *WMD was reported as a control-intervention effect; the values were reversed here to make the direction of the blood pressure result comparable to other results in the table. | |||||
| «Filippou CD, Tsioufis CP, Thomopoulos CG, ym. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Ana»1 | 30 2742/ 2803 | 2-52 weeks, mean 15.3 | N/A | N/A | SBP MD −3.2 mmHg (−4.2 to −2.3) DPB MD -2.5 mmHg (−3.5 to −1.5) |
| «Fu J, Liu Y, Zhang L, ym. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020;9(19):e016804 »2 | 9 Total 1022 | 4-12 weeks | N/A | N/A | With prehypertension to established hypertension SBP WMD* -6.97 (CrI -4.50 to 9.47) DBP WMD* -3.54 (CrI -1.80 to -5.28) |
| «Fu J, Liu Y, Zhang L, ym. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020;9(19):e016804 »2 | 4 total 262 | 8 weeks | N/A | N/A | With hypertension SBP WMD* -8.69 (CrI 5.23 to12.19) DBP WMD* -4.54 (CrI -1.91 to -7.18) |
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations. | |||||
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval; N/A=not applicable; SBP=systolic blood pressure; MD=mean difference; DPB=diastolic blood pressure | |||||
| «Cowell OR, Mistry N, Deighton K, ym. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 202»3 | 19 total 4137 | 1,4–260 weeks, median 26 | N/A | N/A | SBP MD -1.4 mmHg (-2.4 to -0.4) DBP MD -1.5 mmHg (-2.7 to -0.3) |
| «Filippou CD, Thomopoulos CG, Kouremeti MM, ym. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled t»4 | 15 1908/1871 | 8-184 weeks | N/A | N/A | SPB MD -3.1 (-4.8, to -1.3) DPB MD -1.6mmHg (-2.6 to -0.6) |
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations. | |||||
The background data (PICO) for the evidence summary was tabulated using AI-assisted methods. The content has been edited and reviewed by the author.
References
- Filippou CD, Tsioufis CP, Thomopoulos CG, ym. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2020;11(5):1150-1160 «PMID: 32330233»PubMed
- Fu J, Liu Y, Zhang L, ym. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020;9(19):e016804 «PMID: 32975166»PubMed
- Cowell OR, Mistry N, Deighton K, ym. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 2021;39(4):729-739 «PMID: 33060448»PubMed
- Filippou CD, Thomopoulos CG, Kouremeti MM, ym. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2021;40(5):3191-3200 «PMID: 33581952»PubMed