Association between the Dietary Approaches to Stop Hypertension (DASH) diet and risk of heart failure: A UK Biobank cohort study

Title : Association between the Dietary Approaches to Stop Hypertension (DASH) diet and risk of heart failure: A UK Biobank cohort study

Abstract:

Background: Evidence supporting dietary interventions for Heart Failure (HF) prevention remains limited. The Dietary Approaches to Stop Hypertension (DASH) diet—characterised by high intake of vegetables, fruits, and whole grains, and lower consumption of sodium and red and processed meat—has been proposed for HF prevention, but population level evidence is sparse.

Aim: To investigate the association of higher adherence to the DASH diet with lower incidence of HF and its risk factors, namely hypertension and Type 2 Diabetes Mellitus (T2DM).

Methods: A prospective cohort analysis was conducted using UK Biobank participants free of HF at baseline (2006–2010), with follow up to 2024. Dietary intake was assessed using ≥2 instances of 24 hour recall. DASH scores were derived and categorised into quintiles. Fine-Gray competing risks Cox models estimated adjusted Hazard Ratios (aHRs) and 95% Confidence Intervals (CIs) for a primary composite outcome of incident HF or HF related death, adjusting for sociodemographic factors, deprivation, obesity, smoking, hypertension, and T2DM and accounting for all cause mortality. Secondary outcomes were incident hypertension and T2DM.

Results: Among 126,040 participants (mean age 56.1±7.8 years; 56% female; 7% with diabetes; 36% with hypertension), followed for a mean of 12 years, 2,931 HF events and 441 HF deaths occurred. Compared with the lowest DASH adherence quintile, the highest quintile had a lower risk of HF after adjustment for sociodemographic factors (aHR 0.79, 95% CI 0.70–0.89, p<0.001) and comorbidities (aHR 0.84, 95% CI 0.75–0.94, p<0.05). Higher DASH adherence was also associated with reduced risk of hypertension (aHR 0.92, 95% CI 0.87–0.98, p<0.05) and T2DM (aHR 0.78, 95% CI 0.68–0.88, p<0.001).

Conclusions: Higher adherence to the DASH diet was associated with lower risk of HF, hypertension, and T2DM, supporting the role of a DASH diet in HF prevention.

Biography:

Lee is a PhD candidate at the University of Sydney’s School of Medicine, based at the Westmead Applied Research Centre. Her doctoral research examines the relationship between diet and heart failure and includes a clinical trial investigating the ketogenic diet in heart failure patients. She is the lead author of Effect of ketone supplementation, a low carbohydrate diet and a ketogenic diet on heart failure measures and outcomes: a systematic review and meta analysis. Lee won first place for her oral presentation at the Charles Perkins Centre’s 11th Annual Symposium 2025. She holds a Master in Teaching and has nearly 20 years of teaching experience, currently teaching Mathematics at Ravenswood School for Girls.