# Dietary Prevention of Heart Failure in Hypertensive Metabolic Syndrome

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2022 · —

## Abstract

Patients with heart failure (HF) account for over 1,200,000 VA outpatient visits per year, and HF remains the
most common cause for hospital admission in the VA. Approximately 1/3 of veterans with HF have `preserved'
ejection fraction (HFpEF), or relatively normal contractile function of the heart; such patients suffer functional
decline and poor quality of life, and half die within 5 years after diagnosis. Risk factors for developing HFpEF
are more common in veterans than the general population, and the burden of HFpEF to the VA system will rise
in the years ahead as these veterans age. Preventive efforts are critical, but are hampered by gaps in
knowledge related to HFpEF pathophysiology. The long term goal of this proposal is to prevent the onset of
HFpEF in at-risk veterans. Hypertension (HTN) confers the highest population-attributable risk for HFpEF,
particularly when accompanied by the metabolic syndrome, a constellation of obesity, insulin resistance, and
dyslipidemia. Animal models of HTN and metabolic syndrome develop HFpEF due to microvascular oxidative
stress and inflammation induced by high sodium intake. Recent data from cardiac biopsies confirm similar
mechanisms in human HFpEF. Dietary sodium restriction is widely recommended to prevent HTN-associated
heart disease in humans, but this advice is now controversial. Few studies have examined how individual
differences in response to sodium intake affect risk. “Salt-sensitive” persons have blood pressure (BP) that
changes in parallel with sodium intake, and commonly develop cardiovascular abnormalities associated with
HFpEF. The overall objective of this proposal is to evaluate salt-sensitivity as a novel, diet-responsive risk
factor for incident HFpEF in veterans with HTN and metabolic syndrome. The central hypothesis is that the
sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD) eating pattern will improve
cardiovascular functional and structural risk factors for HFpEF in veterans with the salt-sensitive phenotype.
Guided by findings in experimental models, cohort studies, and strong preliminary evidence from our research
group, this hypothesis will be tested in a two-phase study and by pursuing three specific aims: 1) Determine
effects of DASH/SRD on functional and structural cardiovascular HFpEF risk factors in salt-sensitive vs. salt-
resistant veterans, 2) measure the effect of an electronically-delivered tailored-messaging intervention on
DASH/SRD adherence, and 3) determine effects of DASH/SRD intervention and adoption on microvascular
function and assess the endothelial glycocalyx as a biomarker of cardiovascular response to DASH/SRD.
Phase 1 of the study is a crossover-randomized comparison of DASH/SRD vs. control diet for two weeks each,
and Phase 2 a 6-month extension to promote DASH/SRD adherence. The salt-sensitive phenotype will be
defined by between-diet changes in 24-hour mean BP during Phase 1. In Phase 2, the efficacy of motivational
interviewing-b...

## Key facts

- **NIH application ID:** 10295149
- **Project number:** 5I01CX001636-05
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** SCOTT L HUMMEL
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-10-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295149

## Citation

> US National Institutes of Health, RePORTER application 10295149, Dietary Prevention of Heart Failure in Hypertensive Metabolic Syndrome (5I01CX001636-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10295149. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*