Abstract 4148050: Correlates of DASH adherence among Adults with Hypertension in the 2013- 2020 National Health and Nutrition Examination Survey

Introduction: Dietary Approaches to Stop Hypertension (DASH) dietary pattern is an effective non-pharmacologic approach to hypertension management. Several factors may influence DASH adherence, hence, we aimed to assess correlates of DASH adherence among adults with hypertension. Methods: We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2013 –2020. The outcome, DASH score was calculated from dietary intake data (fruit and vegetables, fish, whole grains, sugar-sweetened beverages, and sodium) from ≥95th percentile (top/ideal diet) to 1st–24th percentile (bottom/least ideal quartile). Weighted generalized linear models were fitted to examine the correlates between DASH adherence and adult food security, age, gender, race and ethnicity, education, poverty income ratio (PIR), marital status, employment, insurance, supplemental nutrition assistance program (SNAP) receipt. Results: Among a sample of 3303 adults with hypertension; mean age 48 (±)18 years, 52% female; mean DASH score was 26 (±3) points. Key correlates of higher DASH diet adherence in adults with hypertension were full individual food security (β = 0.61, 95% CI: 0.10, 1.13), being Hispanic (β = 1.17, 95% CI: 0.57, 1.77) or Asian (β = 2.06, 95% CI: 1.23, 2.88) compared to Whites, older age (β = 0.05, 95% CI: 0.03, 0.07), female sex (β = 0.65, 95% CI: 0.11, 1.19), college education or higher (β = 1.58, 95% CI: 0.80, 2.36), and being married (β = 0.41, 95% CI: 0.07, 0.75). A higher poverty income ratio of 1-1.99 compared to <1 was also associated with better DASH adherence (β = 0.53, 95% CI: 0.19, 0.87). Conclusions: Adherence to the DASH diet among adults with hypertension in the U.S. varies based on ethnicity, individual food security, marital status, and gender. To improve adherence, targeted support should be provided, addressing the unique needs and circumstances of these different groups.