Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial

Data on the potential beneficial effects of combining diet and exercise on blood pressure ( BP ) are still scarce. A 4‐week randomized controlled clinical trial was undertaken in 40 hypertensive patients with type 2 diabetes with uncontrolled blood pressure ( BP ) in office and daytime ambulatory BP monitoring ( ABPM ). Patients were assigned to follow a Dietary Approaches to Stop Hypertension (DASH) diet associated with advice to increase walking using a pedometer (intervention group) or a diet based on the American Diabetes Association recommendations (control group). The lifestyle intervention caused a greater ABPM (mm Hg) reduction in systolic 24‐hour, diastolic 24‐hour, nighttime systolic, daytime systolic, and daytime diastolic measurements than observed in the control group. In the intervention group there was a decrease in urinary sodium and an increase in urinary potassium, plasma aldosterone, and the number of steps per day ( P <.05). The DASH diet and increased walking were associated with clinically significant reductions in ABPM  values in hypertensive patients with type 2 diabetes.