Modified DASH Diet Yields Significant Blood Pressure Reductions in Diabetes Patients

In a recent study published in JAMA Internal Medicine on June 9, 2025, researchers from Johns Hopkins University have found that a modified version of the DASH (Dietary Approaches to Stop Hypertension) diet can significantly lower blood pressure in adults with type 2 diabetes. The research highlights the pressing health concern as approximately 38.1 million adults in the United States were diagnosed with diabetes in 2021, according to the Centers for Disease Control and Prevention (CDC).

The study, led by Dr. Scott Pilla, Assistant Professor of Medicine at Johns Hopkins University School of Medicine, focused on the DASH4D diet, which is a lower-sodium adaptation of the original DASH diet tailored specifically for individuals with type 2 diabetes. This modification aimed to decrease carbohydrate intake and increase unsaturated fats while ensuring potassium levels were manageable for those with chronic kidney disease—a common comorbidity in diabetic patients.

"The goal of our study was to determine the effectiveness of this modified DASH diet in reducing blood pressure among individuals with diabetes, many of whom are on multiple antihypertensive medications," said Dr. Pilla. The research revealed that participants adhering to the DASH4D diet experienced a clinically meaningful decrease in systolic blood pressure by about 4.6 mmHg and diastolic blood pressure by 2.3 mmHg, outperforming the typical American diet with higher sodium intake.

Dr. Lawrence Appel, a Professor of Medicine at Johns Hopkins and co-developer of the original DASH diet, emphasized the importance of maintaining blood pressure control in diabetic patients. "We found that the DASH4D diet not only helps in managing blood sugar levels but also significantly impacts blood pressure, reducing the risk of serious cardiovascular events," stated Dr. Appel.

During the study, which employed a crossover feeding design, 102 participants consumed four different diets over a span of 20 weeks, with each diet lasting five weeks. The mean age of participants was 66 years, with a demographic representation of 66% women and 87% self-reported as Black. A notable 66% of participants were using two or more antihypertensive medications at the study's outset.

The significance of this study lies in its potential to inform dietary recommendations for the growing population of individuals with type 2 diabetes. High blood pressure is prevalent among this group, often leading to increased risks of stroke and heart disease. The study's findings suggest that dietary changes can complement pharmacological treatments in managing these risks effectively.

As a next step, Dr. Pilla and his team aim to disseminate their findings to the wider public, advocating for affordable and accessible dietary changes that can be integrated into diverse cultural eating habits. "We need to make the DASH4D diet easy to follow for everyone, regardless of their background or dietary preferences," he added.

This research was funded primarily by the Sheikh Khalifa Stroke Institute at Johns Hopkins University, alongside grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. The findings underscore the imperative need for innovative dietary strategies to combat the dual challenges of diabetes and hypertension, paving the way for future studies that could explore further improvements in dietary management for chronic conditions.