Hypertension and obesity are prevalent among veterans and contribute substantially to cardiovascular disease risk. The sodium-restricted Dietary Approaches to Stop Hypertension (DASH-SRD) eating pattern is guideline-recommended for BP control, yet adherence remains low. This randomized trial, published in the American Heart Journal, assessed a remotely delivered intervention to promote and sustain DASH-SRD adoption in veterans with hypertension and obesity.

Participants first completed two weeks of ad-lib diet followed by two weeks of home-delivered DASH-SRD meals (Phase 1). In Phase 2, veterans received five telephone-delivered, dietitian-led motivational interviewing sessions over four months, with or without a mobile application.

Outcomes included DASH adherence (score 0-9 from a 3-day food diary), clinic BP, and urinary sodium:potassium ratio, measured at baseline and at months 1 and 6 of Phase 2. Generalized estimating equations evaluated changes.

Sixty-one veterans (age 67±8 years; 15% female; 16% non-White; body mass index 34.4±5.2 kg/m²) completed the study, with 96% counseling attendance. From baseline to 6 months, DASH adherence improved (1.8±1.6 to 2.3±1.4; p = 0.02), systolic BP decreased (133±17 to 128±15 mmHg; p=0.048), diastolic BP decreased (73±11 to 69±12 mmHg; p = 0.03), and urinary sodium:potassium ratio declined (2.6±1.1 to 1.5±0.8; p<0.001). No significant differences were observed between mobile application plus counseling and counseling alone.

A remotely delivered DASH-SRD program was associated with improved dietary adherence and modest reductions in BP over 6 months. The addition of a mobile application did not confer additional benefit.