Abstract
ABSTRACT
Background
Hypertension control among Chinese older adults remains suboptimal, and the real‐world effectiveness of individualized Dietary Approaches to Stop Hypertension (DASH)‐based nutritional support delivered through community nursing is unclear. This study evaluated its association with 6‐month blood pressure trajectories.
Methods
This retrospective cohort study used electronic health records to compare nurse‐delivered individualized DASH‐based nutritional support with standard care. Propensity score matching (1:1) was performed. The primary outcome was the 6‐month systolic blood pressure (SBP) trajectory, analyzed using linear mixed‐effects models with a Group × Time interaction. Secondary outcomes included diastolic blood pressure (DBP), blood pressure control (
Results
Among 366 eligible patients, 210 were matched (105 per group), with all postmatching standardized mean differences p
interaction
p
p
p
= 0.003). The SBP difference was larger among patients with severe hypertension (−7.5 vs. −3.1 mmHg;
p
interaction
= 0.012). In the higher‐contact subgroup (≥ 3 documented nutritional contacts), the SBP difference was −5.6 mmHg. BMI decreased by 1.2 kg/m
2
(
p
p
= 1.000).
Conclusions
Individualized community‐based DASH nutritional support was associated with more favorable blood pressure trajectories and higher control rates without an observed increase in hypotension. Larger differences were observed among patients with severe baseline hypertension and those with greater documented intervention contact.