Effects of Dietary Approaches to Stop Hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases--incidence: a systematic review and meta-analysis on observational prospective studies.

BACKGROUND Cardiovascular diseases (CVDs) are a group of disorders affecting heart and blood vessels. However, protective roles are proposed for Dietary Approaches to Stop Hypertension (DASH)-style diets. OBJECTIVE The aim of this review was to summarize and if possible quantify the longitudinal effects of a DASH-style diet on the incidence of CVDs. DESIGN Pubmed, ISI web of science, and EMBASE were searched and cohort studies that examined the DASH-style diet in relation to CVDs, coronary heart disease (CHD), stroke, and heart failure (HF) were selected. Cohort studies which included participants with specific CVD risk factors like diabetes mellitus, metabolic syndrome, obesity or hypertension were excluded from review. Relative risks (RRs) that were reported for fully adjusted models and their confidence intervals were extracted for meta-analysis. RESULTS Regarding the adherence to the DASH diet and the incidence of CVDs, stroke, CHD, and HF, only 6 studies met our criteria to be included in this systematic review. Meta-analysis showed that imitating a DASH-like diet can significantly reduce CVDs (RR = 0.80; 95% confidence interval [CI], 0.74-0.86; P < 0.001), CHD (RR = 0.79; 95% CI, 0.71-0.88; P < 0.001), stroke (RR = 0.81, 95% CI, 0.72-0.92; P < 0.001), and HF (RR= 0.71, 95% CI, 0.58-0.88; P < 0.001) risk. A linear and negative association was obtained between DASH-style diet concordance and all CVDs, as well. CONCLUSION In conclusion, our results showed that a DASH-like diet can significantly protect against CVDs, CHD, stroke, and HF risk by 20%, 21%, 19% and 29%, respectively. Furthermore, there is a significant reverse linear association between DASH diet consumption and CVDs, CHD, stroke, and HF risk.