UMass Chan Medical School Faculty Publications

UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine; Department of Obstetrics and Gynecology; Department of Family Medicine and Community Health; School of Medicine; Center for Integrated Primary Care

Publication Date


Document Type

Article Postprint


Cardiology | Cardiovascular Diseases | Dietetics and Clinical Nutrition | Obstetrics and Gynecology | Women's Health


BACKGROUND: Hypertension in pregnancy is a leading cause of maternal morbidity and mortality in the United States. Although the Dietary Approaches to Stop Hypertension (DASH) diet is recommended for all adults with hypertension, rates of DASH adherence and anti-hypertensive medications use in women of child-bearing age is unknown.

OBJECTIVES: To determine DASH adherence and anti-hypertensive medication use in women of child-bearing age.

METHODS: In the National Health and Nutrition Examination Surveys from 2001-2016, we estimated DASH adherence among women of child-bearing age (20-50 years). We derived a DASH score (0-9) based on 9 nutrients, with DASH adherence defined as DASH score > /=4.5. Hypertension was defined by blood pressure (BP) > /=130/80 mm Hg or anti-hypertensive medication use. DASH scores were compared across BP categories and anti-hypertensive medication use was categorized.

RESULTS: Of the 7782 women, the mean age (SE) was 32.8 (0.2) years, 21.4% were non-Hispanic Black, and 20.3% had hypertension. The mean DASH score was 2.11 (0.06) for women with self-reported hypertension and 2.40 (0.03) for women with normal BP (P < 0.001). DASH adherence was prevalent in 6.5% of women with self-reported hypertension compared to 10.1% of women with normal BP (P < 0.05). Self-reported hypertension is predominantly managed with medications (84.8%), while DASH-adherence has not improved in these women from 2001-2016. Moreover, 39.5% of US women of child-bearing age are taking medications contraindicated in pregnancy.

CONCLUSIONS: Given the benefits of optimized BP during pregnancy, this study highlights the critical need to improve DASH adherence and guide prescribing among women of child-bearing age.


DASH diet, anti-hypertensive therapy, blood pressure, nutrition, women of child-bearing age

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This is a pre-copyedited, author-produced version of an article accepted for publication in the American Journal of Hypertension following peer review. The version of record is available online at Accepted manuscript posted after 12-month embargo as allowed by the publisher's self-archiving policy at

DOI of Published Version



Kovell LC, Maxner B, Ayturk D, Moore Simas TA, Harrington CM, McManus DD, Gardiner P, Aurigemma GP, Juraschek SP. Dietary Habits and Medications to Control Hypertension among Women of Child-bearing Age in the United States from 2001-2016. Am J Hypertens. 2021 Mar 8:hpab041. doi: 10.1093/ajh/hpab041. Epub ahead of print. PMID: 33693539. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

American journal of hypertension

PubMed ID