DASH & Low-Sodium Diet for Hypertension

The DASH diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis ( Dietary Approaches to Stop Hypertension Dietary Approaches To Stop Hypertension Dietary recommendations that promote reduction in or prevention of high blood pressure. Recommendations include increasing intake of fruits and vegetables, and high-fiber, low-fat foods and reducing the intake of dietary sodium and high fat foods. Hypertension) is an evidence-based eating plan designed to lower blood pressure and reduce cardiovascular risk. Emphasizing fruits, vegetables, whole grains, lean LEAN Quality Measurement and Improvement proteins Proteins Linear polypeptides that are synthesized on ribosomes and may be further modified, crosslinked, cleaved, or assembled into complex proteins with several subunits. The specific sequence of amino acids determines the shape the polypeptide will take, during protein folding, and the function of the protein. Energy Homeostasis, and low-fat dairy while limiting sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia and saturated fats Fats The glyceryl esters of a fatty acid, or of a mixture of fatty acids. They are generally odorless, colorless, and tasteless if pure, but they may be flavored according to origin. Fats are insoluble in water, soluble in most organic solvents. They occur in animal and vegetable tissue and are generally obtained by boiling or by extraction under pressure. They are important in the diet (dietary fats) as a source of energy. Energy Homeostasis, it provides essential nutrients like potassium Potassium An element in the alkali group of metals with an atomic symbol k, atomic number 19, and atomic weight 39. 10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. Hyperkalemia, magnesium Magnesium A metallic element that has the atomic symbol mg, atomic number 12, and atomic weight 24. 31. It is important for the activity of many enzymes, especially those involved in oxidative phosphorylation. Electrolytes, and calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes. Clinically recommended for hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension management, it improves lipid profiles, supports weight control, and promotes long-term heart health through sustainable dietary changes.

Last updated: Oct 10, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Overview

Definition and Purpose

  • DASH Diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis: The DASH ( Dietary Approaches to Stop Hypertension Dietary Approaches To Stop Hypertension Dietary recommendations that promote reduction in or prevention of high blood pressure. Recommendations include increasing intake of fruits and vegetables, and high-fiber, low-fat foods and reducing the intake of dietary sodium and high fat foods. Hypertension) diet is an evidence-based eating plan developed to lower blood pressure and reduce the risk of cardiovascular disease. It is not a restrictive, short-term diet but rather a flexible, lifelong approach to healthy eating.
  • Primary Purpose: The diet’s main goal is to lower high blood pressure ( hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension). It achieves this by emphasizing foods rich in nutrients known to reduce blood pressure while limiting foods that can elevate it.

Clinical Indications

  • Hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension: The DASH diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis is a first-line, non-pharmacological intervention for individuals with Stage 1 Stage 1 Trypanosoma brucei/African trypanosomiasis hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension (130-139 mmHg systolic) and an adjunctive therapy for those requiring medication.
  • Elevated Blood Pressure: It is also indicated for individuals with elevated blood pressure (120-129/<80 mmHg) who are at risk of developing hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension.
  • Cardiovascular Risk Reduction: Due to its proven effects on lowering LDL cholesterol Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Cholesterol Metabolism and blood pressure, it is recommended for individuals at high risk for cardiovascular disease.
  • Prevalence Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. Measures of Disease Frequency Context: Hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension is a significant public health issue, affecting over 1 billion adults globally and nearly half of adults in the United States, making dietary interventions a critical component of population health management.

Mechanism of Action

  • The antihypertensive effect of the DASH diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis is multifactorial, resulting from the synergistic effects of several key nutrients and the reduction of sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia.
  • Sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia Reduction: High dietary sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia can impair renal sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia excretion, leading to fluid retention, increased blood volume, and elevated blood pressure, particularly in salt-sensitive individuals. The diet’s sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia restriction helps mitigate this effect by decreasing extracellular fluid Extracellular fluid The fluid of the body that is outside of cells. It is the external environment for the cells. Body Fluid Compartments volume and vascular resistance Resistance Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. Ventilation: Mechanics of Breathing.
  • Increased Potassium Potassium An element in the alkali group of metals with an atomic symbol k, atomic number 19, and atomic weight 39. 10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. Hyperkalemia: Potassium Potassium An element in the alkali group of metals with an atomic symbol k, atomic number 19, and atomic weight 39. 10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. Hyperkalemia counteracts the effects of sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia by promoting its excretion in urine, which helps to lower blood pressure. It also relaxes vascular smooth muscle.
  • Increased Magnesium Magnesium A metallic element that has the atomic symbol mg, atomic number 12, and atomic weight 24. 31. It is important for the activity of many enzymes, especially those involved in oxidative phosphorylation. Electrolytes: Magnesium Magnesium A metallic element that has the atomic symbol mg, atomic number 12, and atomic weight 24. 31. It is important for the activity of many enzymes, especially those involved in oxidative phosphorylation. Electrolytes functions as a natural calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes channel blocker. It competes with calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes at binding sites on vascular smooth muscle cells, promoting vasodilation Vasodilation The physiological widening of blood vessels by relaxing the underlying vascular smooth muscle. Pulmonary Hypertension Drugs and reducing peripheral resistance Resistance Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. Ventilation: Mechanics of Breathing.
  • Increased Calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes: Adequate calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes intake is inversely associated with blood pressure. It plays a complex role in vascular smooth muscle contractility and interacts with hormonal systems that regulate blood pressure.

Components of the Intervention

Key Principles

  • The diet is characterized by high intake of fruits, vegetables, and whole grains.
  • It includes fat-free or low-fat dairy products, fish FISH A type of in situ hybridization in which target sequences are stained with fluorescent dye so their location and size can be determined using fluorescence microscopy. This staining is sufficiently distinct that the hybridization signal can be seen both in metaphase spreads and in interphase nuclei. Chromosome Testing, poultry, beans, and nuts.
  • It limits foods high in saturated fat (e.g., fatty meats, full-fat dairy) to less than 5% of total daily calories, cholesterol Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Cholesterol Metabolism to less than 150 mg/day, with total fat comprising 27% of daily calories. 
  • Sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia intake is limited to either 2,300 mg/day (standard) or 1,500 mg/day (lower-sodium version for greater efficacy).
  • The diet is high in potassium Potassium An element in the alkali group of metals with an atomic symbol k, atomic number 19, and atomic weight 39. 10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. Hyperkalemia (3,500-5,000 mg/day), magnesium Magnesium A metallic element that has the atomic symbol mg, atomic number 12, and atomic weight 24. 31. It is important for the activity of many enzymes, especially those involved in oxidative phosphorylation. Electrolytes (500 mg/day), and calcium Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Electrolytes (1,250 mg/day). 

Recommended Food Groups and Servings

  • The following table outlines the recommended daily and weekly servings based on a 2,000-calorie diet, which serves as a baseline for patient counseling.
Table: Dietary Recommendations
Food Group Daily/Weekly Servings Examples for Patient Education
Grains 6–8 per day Whole-wheat bread, brown rice, oatmeal, quinoa
Vegetables 4–5 per day Broccoli, carrots, spinach, sweet potatoes, tomatoes
Fruits 4–5 per day Apples, bananas, berries, oranges, peaches
Fat-Free or Low-Fat Dairy 2–3 per day Skim milk, low-fat yogurt, reduced-fat cheese
Lean LEAN Quality Measurement and Improvement Meats, Poultry, and Fish FISH A type of in situ hybridization in which target sequences are stained with fluorescent dye so their location and size can be determined using fluorescence microscopy. This staining is sufficiently distinct that the hybridization signal can be seen both in metaphase spreads and in interphase nuclei. Chromosome Testing 6 oz or less per day Skinless chicken, fish FISH A type of in situ hybridization in which target sequences are stained with fluorescent dye so their location and size can be determined using fluorescence microscopy. This staining is sufficiently distinct that the hybridization signal can be seen both in metaphase spreads and in interphase nuclei. Chromosome Testing (salmon, tuna), lean LEAN Quality Measurement and Improvement beef
Nuts, Seeds, and Legumes 4–5 per week Almonds, walnuts, kidney beans, lentils
Fats Fats The glyceryl esters of a fatty acid, or of a mixture of fatty acids. They are generally odorless, colorless, and tasteless if pure, but they may be flavored according to origin. Fats are insoluble in water, soluble in most organic solvents. They occur in animal and vegetable tissue and are generally obtained by boiling or by extraction under pressure. They are important in the diet (dietary fats) as a source of energy. Energy Homeostasis and Oils 2–3 per day Olive oil, canola oil, avocado, light salad dressing
Sweets and Added Sugars 5 or less per week Maple syrup, hard candy, fruit-flavored gelatin

Implementation and Monitoring

Practical Guidance for Implementation

  • Clinicians can advise patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship to adopt the diet gradually to improve long-term adherence.
  • Counseling Points for Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship:
    • Increase Fruits and Vegetables: Advise adding one serving of vegetables at lunch and dinner and incorporating fruit as a snack or dessert.
    • Prioritize Whole Grains: Recommend swapping refined grains like white bread and pasta for whole-grain alternatives.
    • Sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia Awareness: Educate patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship that over 70% of dietary sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia comes from processed and restaurant foods, not the salt shaker.
    • Reading Nutrition Labels Labels Analogs of those substrates or compounds which bind naturally at the active sites of proteins, enzymes, antibodies, steroids, or physiological receptors. These analogs form a stable covalent bond at the binding site, thereby acting as inhibitors of the proteins or steroids. Immunoassays: Teach patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship to check for sodium Sodium A member of the alkali group of metals. It has the atomic symbol na, atomic number 11, and atomic weight 23. Hyponatremia content, aiming for products with 5% Daily Value (DV) or less per serving. Encourage to aim for <2,300 mg/day (or <1,500 mg/day for greater efficacy).
    • Cooking Strategies: Recommend flavoring foods with herbs, spices, and citrus instead of salt and preparing meals from scratch when possible. Baking, grilling, and steaming are preferred over frying. 
    • Dining Out: Advise patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship to request that meals be prepared without added salt and to ask for sauces and dressings on the side. Encourage vegetable-rich dishes, and avoid processed menu items.

Monitoring Efficacy and Adherence

  • Blood Pressure Reduction: The primary outcome for monitoring is a reduction in blood pressure. Studies have shown that the DASH diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis can lower blood pressure in as little as two weeks.
  • Dietary Recall: Adherence can be assessed through 24-hour dietary recalls, focusing on the frequency and portion sizes of the recommended food groups.
  • Clinical Outcome Tracking: In addition to blood pressure, it can be beneficial to monitor changes in body weight, waist circumference Waist circumference Measure of abdominal obesity and is associated with increased cardiovascular risks. Obesity, HbA1c HbA1c Products of non-enzymatic reactions between glucose and hemoglobin a, occurring as a minor fraction of the hemoglobin components of human erythrocytes. Hemoglobin a1c is hemoglobin a with glucose covalently bound to the terminal valine of the beta chain. Glycated hemoglobin a is used as an index of the average blood sugar level over a lifetime of erythrocytes. Diabetes Mellitus, and lipid profiles.  

Clinical Considerations

Additional Health Benefits

  • Lipid Profile Lipid profile Lipid Disorders Improvement: The DASH diet DASH diet A diet rich in fruits and vegetables, and low in fats, dairy, and saturated/total fats. Carotid Artery Stenosis has been shown to lower total cholesterol Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Cholesterol Metabolism and LDL cholesterol Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Cholesterol Metabolism.
  • Weight Management: While not designed as a weight-loss diet, the emphasis on nutrient-dense, high-fiber foods can aid in weight management when combined with calorie control.
  • Reduced Risk of Other Conditions: The diet has been ranked highly for improving the health of individuals with diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus and prediabetes.

Potential Challenges or Side Effects

  • Gastrointestinal Discomfort: Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship new to a high-fiber diet may initially experience gas and bloating Bloating Constipation. This can be mitigated by gradually increasing the intake of high-fiber foods over several weeks.
  • Cost and Accessibility: A diet rich in fresh produce may be more expensive and less accessible for some patient populations. Counseling should include strategies like using frozen or canned (no-salt-added) vegetables, shopping seasonally, and increasing intake of legumes and affordable fish FISH A type of in situ hybridization in which target sequences are stained with fluorescent dye so their location and size can be determined using fluorescence microscopy. This staining is sufficiently distinct that the hybridization signal can be seen both in metaphase spreads and in interphase nuclei. Chromosome Testing options to address these barriers.  

References

  1. Akinbami, L. J., et al. (2024). Hypertension Prevalence, Awareness, Treatment, and Control Among Adults: United States, August 2021–August 2023. NCHS Data Brief, (511). https://www.cdc.gov/nchs/products/databriefs/db511.htm
  2. Beaney, T., et al. (2024). Age-Related Blood Pressure Gradients Are Associated With Blood Pressure Control and Global Population Outcomes. Hypertension, 81(10). https://www.researchgate.net/publication/382939569_Age-Related_Blood_Pressure_Gradients_Are_Associated_With_Blood_Pressure_Control_and_Global_Population_Outcomes 
  3. National Heart, Lung, and Blood Institute. (2025). DASH Eating Plan. https://www.nhlbi.nih.gov/education/dash-eating-plan
  4. National Institutes of Health. (2023). Lower sodium could reduce blood pressure in most people. https://www.nih.gov/news-events/nih-research-matters/lower-sodium-could-reduce-blood-pressure-most-people 
  5. Gardner, C. D., Vadiveloo, M. K., Petersen, K. S., et al. (2023). Popular dietary patterns: Alignment with American Heart Association 2021 dietary guidance: A scientific statement from the American Heart Association. Circulation, 147(22), 1715–1730. https://doi.org/10.1161/CIR.0000000000001146
  6. Jones, D. W., Ferdinand, K. C., Taler, S. J., et al. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. https://doi.org/10.1161/CIR.0000000000001356
  7. Oh, Y. S., & Appel, L. J. (2023). Salt-Sensitive Hypertension and the Kidney. Hypertension, 80(10), 1946–1955. https://pubmed.ncbi.nlm.nih.gov/38545804/
  8. U.S. Department of Health and Human Services. (2023). Lower Sodium Foods: Shopping List. https://odphp.health.gov/myhealthfinder/health-conditions/heart-health/lower-sodium-foods-shopping-list
  9. Chiavaroli, L., Viguiliouk, E., Nishi, S. K., et al. (2019). DASH dietary pattern and cardiometabolic outcomes: An umbrella review of systematic reviews and meta-analyses. Nutrients, 11(2), E338. https://doi.org/10.3390/nu11020338
  10. Yannakoulia, M., & Scarmeas, N. (2024). Diets. The New England Journal of Medicine, 390(22), 2098–2106. https://doi.org/10.1056/NEJMra2211889
  11. Van Horn, L., Carson, J. A., Appel, L. J., et al. (2016). Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) guidelines: A scientific statement from the American Heart Association. Circulation, 134(22), e505–e529. https://doi.org/10.1161/CIR.0000000000000462
  12. Fu, J., Liu, Y., Zhang, L., Zhou, L., Li, D., Quan, H., Zhu, L., Hu, F., Li, X., Meng, S., Yan, R., Zhao, S., Onwuka, J. U., Yang, B., Sun, D., & Zhao, Y. (2020). Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. Journal of the American Heart Association, 9(19), e016804. https://doi.org/10.1161/JAHA.120.016804

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