DIETARY APPROACHES TO STOP HYPERTENSION 2 (DASH2)

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The objective of this ancillary study in DASH2 is to determine the impact of dietary patterns on markers of hemostasis, endothelial damage and inflammation as an ancillary study to DASH2, a feeding study. These factors and pathways have been associated with the occurrence of clinical cardiovascular events and represent key components in the atherosclerotic process. The main objective of DASH2 is to assess the effects of 3 salt levels in 2 dietary patterns on blood pressure in 100 adults with systolic blood pressure 120-159 mmHg and diastolic blood pressure 80 to 95 mmHg. For two weeks, participants are fed a control diet, low in fruits, vegetables, and dairy products, with fat and salt content typical of US consumption. Participants are then randomized in a parallel arm design to (1) the control diet or (2) a "combination" diet rich in fruits, vegetables, and low-fat dairy products, and reduced in saturated and total fat. Within each diet, participants receive three different sodium levels (50 mmol/d, 100 mmol/d, and 150 mmol/d), each for 30 days. Study participants will be the 100 healthy volunteers to be enrolled in DASH2 at the Johns Hopkins General Clinical Research Center. To date, we have collected blood from 35 randomized participants enrolled in the first of three feeding cohorts. Measurements for this ancillary study are taken at the last screening visit and at the conclusion of the study. No intermediate measurements are taken as sodium is not thought to play a major role in influencing the levels of the markers in question. Fibrinolytic activity is evaluated by measuring tissue plasminogen activator antigen (TPA ag) and the activity of its major inhibitor, plasminogen activator inhibitor (PAI-1 activity). Furthermore, activity coagulation is measured through Factor VII coagulant activity, homocysteine and fibrinogen measrements. Each of these factors has been independently associated with risk of major atherosclerotic events. Endothelial damage is measured by thrombomodulin (TM) and von Willebrand's factor (vWF). Finally, two markers of inflammation, C-reactive protein (CRP) and total WBC, are measured.