Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes: The Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) Randomized Clinical Trial
Primary result · End-of-period systolic BPResult — go to the resultReduction 4.6 mm Hg 95% CI 7.2–2.0Authors' conclusion
This randomized clinical trial found that, for adults with type 2 diabetes, most of whom were treated with multiple antihypertensive medications, the DASH4D diet combined with sodium reduction achieved a clinically relevant reduction in blood pressure, primarily from sodium reduction.
Study context
- Population
- Adults with T2D, systolic BP 120 to 159 mm Hg and diastolic BP <100 mm Hg; mean age 66 years, 66% women, 87% Black, 66% on ≥2 antihypertensive medications85 completed all periods
- Participants
- 102 adults
- Comparison
- DASH4D diet with lower sodium vs comparison diet with higher sodium
- Primary endpoint
- End-of-period systolic BP
- Follow-up
- End of each 5-week period
Methodological details4-period crossover, controlled feeding, weight held constant, single community-based study center, June 2021 to June 2024, Participants were provided all their food and ate no outside food
- 4-period crossover
- Controlled feeding
- Weight held constant
- Single community-based study center
- June 2021 to June 2024
- Participants were provided all their food and ate no outside food
Primary result
As reported in the abstract
end of 5-week period
Reduction
4.6 mm Hg
95% CI 7.2–2.0
P < 0.001
Secondary outcomes
| Outcome | Reduction (mm Hg) (95% CI) |
|---|---|
| End-of-period diastolic BP · end of 5-week periodDASH4D lower sodium vs Comparison higher sodium · lower with DASH4D lower sodium | 2.3 (3.7–0.9) |
Timing and source of BP reduction
- Most BP reduction occurred during the first 3 weeks of each diet
- Effect of sodium reduction appeared stronger than effect of DASH4D diet
Safety
- Adverse events were infrequent in each diet
Original publication
Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes: The DASH4D Randomized Clinical Trial. JAMA Intern Med. Published 1 August 2025. doi:10.
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