Dietary modification of blood pressure-lowering effects of antihypertensive drugs - a scoping review

Hypertension remains a major public health concern. Diet is a well established modifiable risk factor for hypertension and may interact with antihypertensive drugs. This scoping review aimed to identify dietary factors that modify the blood pressure (BP) lowering effects of antihypertensive drugs. The review protocol was preregistered on Zenodo and was guided by PRISMA-ScR. Studies were included when participants were treated with a specified antihypertensive drug class and a dietary intervention. Of 7346 screened reports, 43 met inclusion criteria and investigated 16 dietary factors across five antihypertensive drug classes. Evidence for effect modification was available for eight dietary factors in ten drug-diet combinations. Of these, seven combinations suggested modification of the BP lowering effect of antihypertensive drugs, either a trend toward enhancement or attenuation. In addition, sodium restriction, potassium and magnesium supplementation showed consistent BP-lowering effects when added to drug therapy. These findings support the potential of integrating dietary considerations into antihypertensive treatment strategies to improve BP control.