Association Between Dietary Pattern Adherence and Blood Pressure Control Among U.S. Adults: A Descriptive Analysis of National Health and Nutrition Examination Survey (NHANES) 2017-2020 Data

BACKGROUND: Hypertension continues to be one of the most pressing health challenges worldwide, contributing significantly to cardiovascular disease and premature death. Dietary approaches aimed at improving blood pressure control have shown promise, yet their effectiveness in real-world settings across diverse populations in the United States is not fully understood. OBJECTIVE: To examine, in a cross-sectional analysis, the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and blood pressure control status among hypertensive U.S. adults using the National Health and Nutrition Examination Survey (NHANES) 2017-2020 data. METHODS: This cross-sectional study analyzed 2,004 unweighted hypertensive adults representing 53,882,767 weighted U.S. adults. DASH adherence was classified into low, moderate, and high categories using the Food Patterns Equivalents Database (FPED). Survey-weighted logistic regression was applied to assess associations between DASH adherence and controlled blood pressure, adjusting for sociodemographic, behavioral, and clinical factors. RESULTS: No significant association was observed between DASH adherence and blood pressure control (p>0.05). Predicted probabilities of control were 0.45, 0.42, and 0.43 for low, moderate, and high adherence, respectively. CONCLUSION: Higher DASH adherence did not significantly improve blood pressure control among U.S. adults with hypertension, highlighting the need for enhanced dietary adherence strategies in real-world settings.