April 23, 2025 — A recent study published in the American Journal of Preventive Cardiology reveals that combining the DASH (Dietary Approaches to Stop Hypertension) diet with reduced sodium intake significantly lowers the estimated 10-year risk of atherosclerotic cardiovascular disease (ASCVD).
The findings are based on a secondary analysis of the landmark DASH-Sodium trial and suggest that each intervention independently reduces cardiovascular risk—but offers the greatest benefit when used together.
Cardiovascular Disease Still a Leading Threat
Cardiovascular disease (CVD) remains the world’s leading cause of death, with over half of all cases attributed to modifiable lifestyle factors such as diet and exercise. In the United States, high sodium intake is particularly problematic, with more than 90% of adults consuming amounts above recommended limits.
The DASH diet, endorsed by national guidelines, promotes fruits, vegetables, whole grains, and low-fat dairy while minimizing added sugars, saturated fats, and cholesterol. It has been linked to improved heart health and reduced long-term disease risk.
Previous research established that both DASH and sodium reduction lower blood pressure, but the long-term effect on ASCVD risk had not been thoroughly assessed until now.
Study Details
The new analysis draws on data from the original DASH-Sodium trial, conducted between 1997 and 1999 across four U.S. clinical centers. The randomized, controlled feeding study involved adults with elevated blood pressure who were not on antihypertensive medications and had no significant comorbidities such as heart disease or diabetes.
Participants were assigned to either the DASH diet or a typical American diet and consumed meals with three varying sodium levels—high (about 3,500 mg/day), medium (around 2,400 mg/day), and low (approximately 1,150 mg/day)—each for 30-day periods with breaks in between. All meals were provided by the study team to ensure consistency.
Researchers calculated each participant’s 10-year ASCVD risk using the Pooled Cohort Equation, factoring in static elements like age and smoking, alongside dynamic measures such as cholesterol levels and blood pressure taken after each diet phase.
Results Show Combined Diet Approach Is Most Effective
Data from 390 participants showed that both sodium reduction and the DASH diet independently lowered estimated ASCVD risk over ten years. The DASH diet alone led to an absolute risk reduction of 0.12% compared to the control diet, while low sodium intake yielded even greater benefits.
The most notable results came from combining the DASH diet with low sodium intake, which led to an absolute risk reduction of 0.35%—a relative improvement of over 14% compared to a high-sodium, standard American diet.
Subgroup analysis revealed stronger effects in women, Black participants, and individuals with stage 2 hypertension. The researchers did not observe significant differences across age, obesity, or smoking status.
However, the study’s ability to assess risk in other racial or ethnic groups was limited, as race was categorized only as Black or non-Black.
Limitations and Future Directions
While the findings support the role of diet and sodium intake in cardiovascular health, the researchers noted limitations. The dietary intervention periods lasted only 30 days, and the study excluded people with existing heart disease, diabetes, or those taking blood pressure medications—factors that may affect how broadly the results can be applied.
Additionally, the study assessed changes in risk scores, not actual clinical events. As such, more long-term research is needed to evaluate whether these dietary strategies prevent heart attacks or strokes.
Still, the results reinforce public health recommendations to lower sodium intake and adopt heart-healthy diets. Even moderate sodium reductions showed measurable benefits, underscoring the importance of realistic, sustainable dietary changes for reducing cardiovascular risk.
You Might Be Interested In:
-
Many Vegans Get Enough Protein but Fall Short on Key Amino Acids
-
Brown Rice May Pose Arsenic Risk for Young Children, Study Warns
-
Only 13% of French Adults Have Optimal Heart Health, Study Finds Introduction
