***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Although the Dietary Approaches to Stop Hypertension ( DASH ) diet is an accepted nonpharmacologic treatment for hypertension , little is known about what patient characteristics affect dietary adherence and what level of adherence is needed to reduce blood pressure ( BP ) . OBJECTIVE Our aim was to determine what factors predict dietary adherence and the extent to which dietary adherence is necessary to produce clinical ly meaningful BP reductions . DESIGN Ancillary study of the ENCORE ( Exercise and Nutrition Interventions for Cardiovascular Health ) trial -- a 16-week r and omized clinical trial of diet and exercise . PARTICIPANTS / SETTING Participants included 144 sedentary , overweight , or obese adults ( body mass index 25 to 39.9 ) with high BP ( systolic 130 to 159 mm Hg and /or diastolic 85 to 99 mm Hg ) . INTERVENTION Patients were r and omized to one of three groups : DASH diet alone , DASH diet plus weight management , and Usual Diet Controls . MAIN OUTCOMES MEASURES Our primary outcomes were a composite index of adherence to the DASH diet and clinic BP . STATISTICAL ANALYSES PERFORMED General linear models were used to compare treatment groups on post-treatment adherence to the DASH diet . Linear regression was used to examine potential predictors of post-treatment DASH adherence . Analysis of covariance was used to examine the relation of adherence to the DASH diet and BP . RESULTS Participants in the DASH diet plus weight management ( 16.1 systolic BP [ SBP ] ; 95 % CI 13.0 to 19.2 mm Hg and 9.9 diastolic BP [ DBP ] ; 95 % CI 8.1 to 11.6 mm Hg ) and DASH diet alone ( 11.2 SBP ; 95 % CI 8.1 to 14.3 mm Hg and 7.5 DBP ; 95 % CI 5.8 to 9.3 mm Hg ) groups showed significant reductions in BP in comparison with Usual Diet Controls participants ( 3.4 SBP ; 95 % CI 0.4 to 6.4 mm Hg and DBP 3.8 ; 95 % CI 2.2 to 5.5 mm Hg ) . Greater post-treatment consumption of DASH foods was noted in both the DASH diet alone ( mean = 6.20 ; 95 % CI 5.83 to 6.57 ) and DASH diet plus weight management groups ( mean = 6.23 ; 95 % CI 5.88 to 6.59 ) compared with Usual Diet Controls ( mean = 3.66 ; 95 % CI 3.30 to 4.01 ; P<0.0001 ) , and greater adherence to the DASH diet was associated with larger reductions in clinic SBP and DBP ( P ≤ 0.01 ) . Only ethnicity predicted dietary adherence , with African Americans less adherent to the DASH diet compared with whites ( 4.68 ; 95 % CI 4.34 to 5.03 vs 5.83 ; 95 % CI 5.50 to 6.11 ; P<0.001 ) . CONCLUSIONS Greater adherence to the DASH diet was associated with larger BP reductions independent of weight loss . African Americans were less likely to be adherent to the DASH dietary eating plan compared with whites , suggesting that culturally sensitive dietary strategies might be needed to improve adherence to the DASH diet R and omized trials have shown that increasing potassium intake lowers blood pressure . However , most previous trials used potassium chloride , whereas potassium in fruits and vegetables is not a chloride salt . It is unclear whether a nonchloride salt of potassium has a greater or lesser effect on blood pressure compared with potassium chloride . We performed a r and omized crossover trial comparing potassium chloride with potassium citrate ( 96 mmol/d , each for 1 week ) in 14 hypertensive individuals . At baseline , blood pressure was 151±16/93±7 mm Hg with a 24-hour urinary potassium of 81±24 mmol . During the r and omized crossover part of the study , blood pressure was 140±12/88±7 mm Hg with potassium chloride ( 24-hour urinary potassium : 164±36 mmol ) and 138±12/88±6 mm Hg with potassium citrate ( 24-hour urinary potassium : 160±33 mmol ) . These blood pressures were significantly lower compared with that at baseline ; however , there was no significant difference in blood pressure  between potassium chloride and potassium citrate , mean difference ( 95 % confidence interval ) : 1.6 ( −2.3 to 5.6 ) mm Hg for systolic and 0.6 ( −2.4 to 3.7 ) mm Hg for diastolic . Our results , in conjunction with the evidence from many previous trials that potassium chloride has a significant blood pressure-lowering effect , suggest that potassium citrate has a similar effect on blood pressure as potassium chloride . These results support other evidence for an increase in potassium intake and indicate that potassium does not need to be given in the form of chloride to lower blood pressure . Increasing the consumption of foods high in potassium is likely to have the same effect on blood pressure as potassium chloride BACKGROUND Weight loss reduces blood pressure , and the Dietary Approaches to Stop Hypertension ( DASH ) diet has also been shown to lower blood pressure . OBJECTIVE Our goal was to assess the effect on blood pressure of 2 weight-reduction diets : a low-fat diet ( LF diet ) and a moderate-sodium , high-potassium , high-calcium , low-fat DASH diet ( WELL diet ) . DESIGN After baseline measurements , 63 men were r and omly assigned to either the WELL or the LF diet for 12 wk , and both diet groups undertook 0.5 h of moderate physical activity on most days of the week . RESULTS Fifty-four men completed the study . Their mean ( + /-SD ) age was 47.9 + /- 9.3 y ( WELL diet  , n = 27 ; LF diet , n = 27 ) , and their mean baseline home systolic and diastolic blood pressures were 129.4 + /- 11.3 and 80.6 + /- 8.6 mm Hg , respectively . Body weight decreased by 4.9 + /- 0.6 kg ( + /-SEM ) in the WELL group and by 4.6 + /- 0.6 kg in the LF group ( P < 0.001 for both ) . There was a greater decrease in blood pressure in the WELL group than in the LF group [ between-group difference ( week 12 -baseline ) in both SBP ( 5.5 + /- 1.9 mm Hg ; P = 0.006 ) and DBP ( 4.4 + /- 1.2 mm Hg ; P = 0.001 ) ] . CONCLUSIONS For a comparable 5-kg weight loss , a diet high in low-fat dairy products , vegetables , and fruit ( the WELL diet ) result ed in a greater decrease in blood pressure than did the LF diet . This dietary approach to achieving weight reduction may confer an additional benefit in reducing blood pressure in those who are overweight K-rich fruit and vegetables may lower blood pressure ( BP ) and improve vascular function . A r and omised controlled trial ( IS RCT N50011192 ) with a cross-over design was conducted in free-living participants with early stages of hypertension ( diastolic BP>80 and < 100 mmHg , not receiving BP-lowering medication ) to test this hypothesis . Following a 3-week run-in period on a control diet , each subject completed four dietary 6-week dietary interventions ( control+placebo capsules , an additional 20 or 40 mmol K(+)/d from fruit and vegetables or 40 mmol potassium citrate capsules/d ) using a Latin square design with a washout period ≥ 5 weeks between the treatment periods . Out of fifty-seven subjects who were r and omised , twenty-three male and twenty-five female participants completed the study ; compliance to the intervention was corroborated by food intake records and increased urinary K(+ ) excretion ; plasma lipids , vitamin C , folate and homocysteine concentrations , urinary Na excretion , and body weight remained were unchanged . On the control diet , mean ambulatory 24 h systolic/diastolic BP were 132·3 ( sd 12·0)/81·9 ( ( SD ) 7·9 ) mmHg , and changes ( Bonferroni 's adjusted 95 % CI ) compared with the control on the diets providing 20 and 40 mmol K(+)/d as fruit and vegetables were 0·8 ( - 3·5 , 5·3)/0·8 ( - 1·9 , 3·5 ) and 1·7 ( - 3·0 , 5·3)/1·5 ( - 1·5 , 4·4 ) , respectively , and were 1·8 ( - 2·1 , 5·8)/1·4 ( - 1·6 , 4·4 ) mmHg on the 40 mmol potassium citrate supplement , and were not statistically significant . Arterial stiffness , endothelial function , and urinary and plasma isoprostane and C-reactive protein ( CRP ) concentrations did not differ significantly between the diets . The present study provides no evidence to support dietary advice to increase K intake above usual UK intakes in the subjects with early stages of hypertension Background The incidence of Hypertension as a major cardiovascular threat is increasing . The best known diet for hypertensives is ' no added salt diet'.In this study we evaluated the effect of ' no added salt diet ' on a hypertensive population with high dietary sodium intake by measuring 24 hour urinary sodium excretion . Methods In this single center r and omized study 80 patients ( 60 cases and 20 controls ) not on any drug therapy for hypertension with mild to moderate hypertension were enrolled .  24 hour holter monitoring of BP and 24 hour urinary sodium excretion  were measured before and after 6 weeks of ' no added salt diet ' . Results There was no statistically significant difference between age , weight , sex , Hyperlipidemia , family history of hypertension , mean systolic and diastolic BP during the day and at night and mean urinary sodium excretion in 24 hour urine of case and control groups . Seventy eight percent of all patients had moderate to high salt intake . After 6 week of ' no added salt diet ' systolic and diastolic BP significantly decreased during the day ( mean decrease : 12.1/6.8 mmhg ) and at night ( mean decrease : 11.1/5.9 mmhg ) which is statistically significant in comparison to control group ( P 0.001 and 0.01).Urinary sodium excretion of 24 hour urine decreased by 37.1 meq/d ± 39,67 mg/dl in case group which is statistically significant in comparison to control group ( p : 0.001).Only 36 % of the patients , after no added salt diet , reached the pretreatment goal of 24 hour urinary sodium excretion of below 100 meq/dl ( P:0.001 ) . Conclusion Despite modest effect on dietary sodium restriction , no added salt diet significantly decreased systolic and diastolic BP and so it should be advised to every hypertensive patient . Trial Registration Clinical trial.govnumber BACKGROUND Low 25-hydroxy-vitamin D ( 25(OH)D ) levels are inversely related to blood pressure ( BP ) and have been associated with incident hypertension . In people living at northern latitudes diminished cholecalciferol synthesis in the winter increases the risk of vitamin D deficiency . We wanted to test the hypothesis that daily cholecalciferol supplementation in the winter lowers BP in patients with hypertension . METHODS We investigated the effect of 75 µg ( 3,000 IU ) cholecalciferol per day in a r and omized , placebo-controlled , double-blind study in 130 hypertensive patients residing in Denmark ( 56º N ) . Ambulatory BP ( 24-h BP ) and arterial stiffness were measured before and after 20 weeks of treatment , that took place between October and March . RESULTS A total of 112 patients ( mean age 61 ± 10 ) with a baseline p-25(OH)D of 23 ± 10 ng/ml completed the study . Compared with placebo , a nonsignificant 3/1 mm Hg ( P = 0.26/0.18 ) reduction was found in 24-h BP . In patients with vitamin D insufficiency ( < 32 ng/ml ) at baseline ( n =  92 ) , 24-h BP decreased by 4/3 mm Hg ( P = 0.05/0.01 ) . Central BP ( CBP ) estimated by applanation tonometry and calibrated with a st and ardized office BP 
    Output:
    
To reduce BP in adults with HTN , there is strong evidence to recommend provision of medical nutrition therapy by an RDN , adoption of the Dietary Approaches to Stop Hypertension dietary pattern , calcium supplementation , physical activity as a component of a  healthy lifestyle , reduction in dietary sodium intake , and reduction of alcohol  consumption in heavy drinkers .
Finally , recommendations related to lowering BP were formulated on vitamin D , magnesium , and the putative role of alcohol consumption in moderate drinkers ( weak evidence ) .