{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:55:33Z","timestamp":1788173733161,"version":"build-2803163510"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background\/Objectives: Dietary adherence to the Dietary Approaches to Stop Hypertension (DASH) pattern is associated with lower blood pressure; however, most prior studies have relied on office-based measurements and non-specific dietary assessment tools. This study examined the association between DASH diet quality, assessed by the validated DASH-Q questionnaire, and 24-h ambulatory blood pressure in treatment-naive adults referred for diagnostic ambulatory blood pressure monitoring (ABPM). Materials and Methods: This cross-sectional study enrolled 227 consecutive treatment-naive adults referred for diagnostic 24-h ABPM at a cardiology outpatient clinic. DASH diet quality was assessed using the validated Turkish version of the DASH-Q questionnaire and categorized as low (&lt;36), moderate (36\u201349), or high (\u226550). Hypertension was defined by ABPM-based thresholds. Multivariable linear regression was performed to identify independent predictors of 24-h mean systolic and diastolic blood pressure, and binary logistic regression was used to evaluate independent predictors of ABPM-defined hypertension, with both models adjusted for age, sex, BMI, smoking, physical activity, and self-reported discretionary salt-adding behavior. Results: DASH-Q total score was the sole statistically significant independent predictor of both 24-h mean systolic blood pressure (B = \u22121.068, 95% CI: \u22121.270 to \u22120.866; \u03b2 = \u22120.589; p &lt; 0.001) and diastolic blood pressure (B = \u22120.560, 95% CI: \u22120.706 to \u22120.414; \u03b2 = \u22120.470; p &lt; 0.001) in the adjusted models. Each one-unit higher DASH-Q score was also associated with 14.6% lower odds of ABPM-defined hypertension (OR = 0.854, 95% CI: 0.820\u20130.890; p &lt; 0.001). Higher DASH-Q scores were further associated with a more favorable metabolic profile, including lower LDL cholesterol, triglycerides, glucose, and C-reactive protein levels. Conclusions: DASH diet quality was independently and inversely associated with 24-h ambulatory blood pressure and the odds of ABPM-defined hypertension in this treatment-naive population. Given the cross-sectional design and the possibility of reverse causality, these results should be interpreted as hypothesis-generating and require confirmation in prospective studies.<\/jats:p>","DOI":"10.3390\/medicina62050974","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:19:52Z","timestamp":1779877192000},"page":"974","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association Between DASH Diet Quality and 24 h Ambulatory Blood Pressure in Treatment-Naive Adults Referred for Diagnostic Monitoring: A Cross-Sectional Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-6383","authenticated-orcid":false,"given":"Nezihe","family":"Otay Lule","sequence":"first","affiliation":[{"name":"Nutrition and Dietetics Department, Faculty of Health Sciences, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9783-173X","authenticated-orcid":false,"given":"Mert Deniz","family":"Savcilioglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-9663","authenticated-orcid":false,"given":"Kemal Ozan","family":"Lule","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Murat","family":"Sucu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"ref_1","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 398, 957\u2013980."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1038\/s41569-021-00559-8","article-title":"Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension","volume":"18","author":"Zhou","year":"2021","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults","volume":"71","author":"Whelton","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH guidelines for the management of arterial hypertension","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae178","article-title":"2024 ESC guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO)","volume":"45","author":"McEvoy","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.jacc.2025.05.007","article-title":"2025 AHA\/ACC\/AANP\/AAPA\/ABC\/ACCP\/ACPM\/AGS\/AMA\/ASPC\/NMA\/PCNA\/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"86","author":"Jones","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1056\/NEJM199704173361601","article-title":"A clinical trial of the effects of dietary patterns on blood pressure","volume":"336","author":"Appel","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1056\/NEJM200101043440101","article-title":"Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet","volume":"344","author":"Sacks","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0007114514003341","article-title":"Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: A systematic review and meta-analysis","volume":"113","author":"Siervo","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chiavaroli, L., Viguiliouk, E., Nishi, S.K., Mejia, S.B., Raheli\u0107, D., Kahleova, H., Salas-Salvad\u00f3, J., Kendall, C.W.C., and Sievenpiper, J.L. (2019). DASH dietary pattern and cardiometabolic outcomes: An umbrella review of systematic reviews and meta-analyses. Nutrients, 11.","DOI":"10.3390\/nu11020338"},{"key":"ref_11","first-page":"1754","article-title":"Dietary Approaches to Stop Hypertension (DASH) diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials","volume":"22","author":"Filippou","year":"2020","journal-title":"J. Clin. Hypertens."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Valenzuela-Fuenzalida, J.J., Bravo, V.S., Valarezo, L.M., Retamal, M.F.D., Leiva, J.M., Bruna-Mej\u00edas, A., Nova-Baeza, P., Orellana-Donoso, M., Suazo-Santiba\u00f1ez, A., and Oyanedel-Amaro, G. (2024). Effectiveness of DASH diet versus other diet modalities in patients with metabolic syndrome: A systematic review and meta-analysis. Nutrients, 16.","DOI":"10.3390\/nu16183054"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1161\/01.HYP.0000170138.56903.7a","article-title":"Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: The Dublin outcome study","volume":"46","author":"Dolan","year":"2005","journal-title":"Hypertension"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1097\/HJH.0000000000000221","article-title":"European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring","volume":"32","author":"Parati","year":"2014","journal-title":"J. Hypertens."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40885-024-00265-w","article-title":"When and how to use ambulatory blood pressure monitoring and home blood pressure monitoring for managing hypertension","volume":"30","author":"Lee","year":"2024","journal-title":"Clin. Hypertens."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1093\/eurheartj\/ehae337","article-title":"Office measurement vs. ambulatory blood pressure monitoring: Associations with mortality in patients with or without diabetes","volume":"45","author":"Mahfoud","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1097\/HJH.0000000000002843","article-title":"2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement","volume":"39","author":"Stergiou","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jneb.2016.09.004","article-title":"Psychometric validation of a brief self-report measure of diet quality: The DASH-Q","volume":"49","author":"Reeve","year":"2017","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_19","unstructured":"\u00c7etin, S.K. (2020). DASH Diyet Kalitesi \u00d6l\u00e7e\u011fi ve Akdeniz Diyetine Ba\u011fl\u0131l\u0131k \u00d6z-Yeterlilik \u00d6l\u00e7e\u011fi\u2019nin Ge\u00e7erlik \u00c7al\u0131\u015fmas\u0131. [Master\u2019s Thesis, Ac\u0131badem Mehmet Ali Ayd\u0131nlar \u00dcniversitesi]."},{"key":"ref_20","first-page":"128","article-title":"Adherence to the DASH dietary pattern is associated with blood pressure and anthropometric indicators in Mexican adults","volume":"39","year":"2022","journal-title":"Nutr. Hosp."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/ijpvm.ijpvm_336_21","article-title":"The association between DASH diet adherence and cardiovascular risk factors","volume":"14","author":"Shoaibinobarian","year":"2023","journal-title":"Int. J. Prev. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1093\/ajh\/hpt106","article-title":"DASH diet score and distribution of blood pressure in middle-aged men and women","volume":"26","author":"Harrington","year":"2013","journal-title":"Am. J. Hypertens."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2174\/0929867331666230706102406","article-title":"The efficacy of Dietary Approaches to Stop Hypertension (DASH) diet on lipid profile: A systematic review and meta-analysis of clinical controlled trials","volume":"32","author":"Sahebkar","year":"2025","journal-title":"Curr. Med. Chem."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1161\/HYPERTENSIONAHA.120.15026","article-title":"2020 International Society of Hypertension global hypertension practice guidelines","volume":"75","author":"Unger","year":"2020","journal-title":"Hypertension"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2147\/VHRM.S379874","article-title":"A heart-healthy diet for cardiovascular disease prevention: Where are we now?","volume":"19","author":"Diab","year":"2023","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_26","first-page":"e44692","article-title":"DASH diet: A review of its scientifically proven hypertension reduction and health benefits","volume":"15","author":"Onwuzo","year":"2023","journal-title":"Cureus"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1056\/NEJMra2211889","article-title":"Diets","volume":"390","author":"Yannakoulia","year":"2024","journal-title":"N. Engl. J. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/974\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:29:42Z","timestamp":1779877782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,17]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["medicina62050974"],"URL":"https:\/\/doi.org\/10.3390\/medicina62050974","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,17]]}}}