Compared to other races, American Indians experience a heavier burden of risk factors for heart disease, including high blood pressure (hypertension), Type 2 diabetes, and smoking. Medications are widely prescribed to lower blood pressure. However, adopting low-sodium, heart-healthy diets – collectively known as DASH (Dietary Approaches to Stop Hypertension) – has been shown to lower blood pressure with or without medication. In addition, these evidence-based dietary approaches can be more cost-effective and sustainable than daily medication.
The basic DASH diet is simple. It calls for eating more fruits, vegetables, and whole grains, while cutting back on foods high in salt. Researchers with Partnerships for Native Health recently launched a study to test the effectiveness of the DASH diet in two urban Native populations. The overall study name is Diet Intervention for Hypertension: Adaptation and Dissemination to Native Communities. We will conduct a randomized controlled trial at each urban site to compare outcomes in two different study groups.
One group will take part in an intervention in which each participant receives a culturally tailored eating plan based on the DASH diet, plus a $30 weekly credit for home delivery of the groceries needed for the diet. The other group will receive an educational brochure on hypertension management plus a $30 weekly credit for unrestricted grocery purchases. Before and after the intervention, we will measure blood pressure in each study group to see if one group shows more improvement than the other.
Both study sites are located in the western U.S. One is Spokane, Washington, where we are collaborating with the NATIVE Project of Spokane. The other is Tulsa, Oklahoma, where our partner is the Indian Healthcare Resource Center. We will enroll 200 participants at each site, for a total of 400 in the full study population. In August 2016, we will conduct focus groups to adapt the intervention to the unique needs of each participating community. Recruitment for the intervention will begin at each site in October 2016.