Mediterranean Diet Reduces 24-Hour Ambulatory Blood Pressure, Blood Glucose, and Lipids: One-Year Randomized, Clinical Trial

&NA;The PREvención con DIeta MEDiterránea (PREDIMED) trial showed that Mediterranean diets (MedDiets) supplemented with either extravirgin olive oil or nuts reduced cardiovascular events, particularly stroke, compared with a control, lower fat diet. The mechanisms of cardiovascular protection remain unclear. We evaluated the 1-year effects of supplemented MedDiets on 24-hour ambulatory blood pressure (BP), blood glucose, and lipids. Randomized, parallel-design, controlled trial was conducted in 2 PREDIMED sites. Diets were ad libitum, and no advice on increasing physical activity or reducing sodium intake was given. Participants were 235 subjects (56.5% women; mean age, 66.5 years) at high cardiovascular risk (85.4% with hypertension). Adjusted changes from baseline in mean systolic BP were −2.3 (95% confidence interval [CI], −4.0 to −0.5) mm Hg and −2.6 (95% CI, −4.3 to −0.9) mm Hg in the MedDiets with olive oil and the MedDiets with nuts, respectively, and 1.7 (95% CI, −0.1 to 3.5) mm Hg in the control group (P<0.001). Respective changes in mean diastolic BP were −1.2 (95% CI, −2.2 to −0.2), −1.2 (95% CI, −2.2 to −0.2), and 0.7 (95% CI, −0.4 to 1.7) mm Hg (P=0.017). Daytime and nighttime BP followed similar patterns. Mean changes from baseline in fasting blood glucose were −6.1, −4.6, and 3.5 mg/dL (P=0.016) in the MedDiets with olive oil, MedDiets with nuts, and control diet, respectively; those of total cholesterol were −11.3, −13.6, and −4.4 mg/dL (P=0.043), respectively. In high-risk individuals, most with treated hypertension, MedDiets supplemented with extravirgin olive oil or nuts reduced 24-hour ambulatory BP, total cholesterol, and fasting glucose. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: ISRCTN35739639.

[1]  F. Hu,et al.  Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial , 2013, BMC Medicine.

[2]  Geoffrey A Head,et al.  European Society of Hypertension position paper on ambulatory blood pressure monitoring. , 2013, Journal of hypertension.

[3]  Dolores Corella,et al.  Primary prevention of cardiovascular disease with a Mediterranean diet. , 2013, The New England journal of medicine.

[4]  A. Trichopoulou,et al.  Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. , 2012, American journal of epidemiology.

[5]  A. Trichopoulou,et al.  Mediterranean diet pyramid today. Science and cultural updates , 2011, Public Health Nutrition.

[6]  P. Barberger‐Gateau,et al.  Olive oil consumption, plasma oleic acid, and stroke incidence , 2011, Neurology.

[7]  R. Lamuela-Raventós,et al.  Mediterranean diet and oxidation: nuts and olive oil as important sources of fat and antioxidants. , 2011, Current topics in medicinal chemistry.

[8]  E. Ros,et al.  Nuts, hypertension and endothelial function. , 2011, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[9]  J. Manson,et al.  Mediterranean diet and incidence and mortality of coronary heart disease and stroke in women , 2009, Circulation.

[10]  M. Martínez-González,et al.  The Mediterranean diet and incidence of hypertension: the Seguimiento Universidad de Navarra (SUN) Study. , 2008, American journal of epidemiology.

[11]  S. Willich,et al.  An update on regional variation in cardiovascular mortality within Europe. , 2007, European heart journal.

[12]  Michael Böhm,et al.  2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). , 2007, Journal of hypertension.

[13]  A. Dominiczak,et al.  2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) , 2007, European heart journal.

[14]  Dolores Corella,et al.  Effects of a Mediterranean-Style Diet on Cardiovascular Risk Factors , 2006, Annals of Internal Medicine.

[15]  J. Wylie-Rosett,et al.  Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee , 2006, Circulation.

[16]  Frank M. Sacks,et al.  Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association , 2006, Hypertension.

[17]  B. Rosner,et al.  Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. , 2005, JAMA.

[18]  K. Reynolds,et al.  Global burden of hypertension: analysis of worldwide data , 2005, The Lancet.

[19]  A. Naska,et al.  Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. , 2004, The American journal of clinical nutrition.

[20]  R. Marfella,et al.  Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. , 2004, JAMA.

[21]  J. Whitworth,et al.  2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension , 2003, Journal of hypertension.

[22]  Majid Ezzati,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[23]  Sudha Seshadri,et al.  Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. , 2002, JAMA.

[24]  George S. Stergiou,et al.  Reproducibility of home, ambulatory, and clinic blood pressure: implications for the design of trials for the assessment of antihypertensive drug efficacy. , 2001, American journal of hypertension.

[25]  G. Bray,et al.  Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet , 2001 .

[26]  G. Bray,et al.  A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. , 1997, The New England journal of medicine.

[27]  R. Stamler,et al.  Implications of the INTERSALT Study , 1991, Hypertension.

[28]  Mark D. Huffman,et al.  Heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[29]  Mark D. Huffman,et al.  Executive summary: heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[30]  Qiang-sun Zheng,et al.  Dietary therapy in hypertension. , 2010, The New England journal of medicine.

[31]  T. Jun Hypertension and endothelial function. , 2009 .