IS THE DASH DIET THE OPTIMAL DIET FOR HEART FAILURE PATIENTS?


Marc A. Silver, M.D., Advocate Christ Medical Center, University of Illinois. IL, USA

Background: For symptomatic heart failure (HF) the major focus remains evidence based pharmacologics and devices. Little guideline evidence exists for nutritional support of HF patients beyond recommendations on limiting sodium excess. Endothelial dysfunction has been recognized as a pathophysiologic mechanism in the progression of HF. We sought to examine the effects of the DASH diet on HF outcomes.

Methods: Forty chronic Stage C, functional class I to III, HF patients were randomized to either be on a DASH diet regimen or follow the general HF dietary recommendations for 1 month. Age was 40 to 84 (mean 64) years; 22 were men. Mean ejection fraction was 42±15. Large and small arterial elasticity (LAE, SAE) at rest were obtained using the pressure pulse contour analysis technique Data collected included exercise capacity as measured by 6-min walk test, weight and DASH diet index score for compliance.

Results: Average DASH diet index score was 6.8/11.The net change in LAE at 1 month was significantly improved in the DASH group when compared to the control group (p < 0.05). Additionally, patients in the DASH group had improved 6-minute walk distance at 1 month compared to their control counterparts (p < 0.05). There was also a trend towards weight loss (-2.5kg) in the DASH group, and weight gain (+0.8kg) in the control group at 1 month. (p <0.05).

Conclusion: Compared to dietary controls, patients who followed a DASH diet had improved large artery compliance and 6 minute walk times. The impact of other diet models on key surrogates of outcome in HF patients is unknown. The DASH diet may be an important adjunctive therapy for patients with symptomatic HF; it is time to focus interest on the potential impact dietary approaches may have on HF outcomes.