Blood pressure is the force pushing blood through the body. High blood pressure, also termed hypertension, occurs when the blood pushes against the walls of the arteries with extreme force. High blood pressure affects almost a quarter of all Americans. While high blood pressure can occur at any age and in all adults, it is particularly common in older-aged persons and in African Americans. People with high blood pressure are at greater risk for heart attack, stroke, and kidney disease.

The contemporary approach to high blood pressure involves both drug therapy and non-drug therapy (lifestlye modification).

Effective non-drug therapies include:

• weight loss
• salt reduction
• exercise
• less alcohol
• overall desirable diet (DASH diet)

Previously, the PREMIER investigators demonstrated in a feeding study that an overall healthy diet (the DASH diet) can reduce blood pressure. One of the goals of PREMIER is to find out the effects of combining these non-drug therapies. Another goal of PREMIER is to test the effects of the DASH diet outside of a feeding study, that is, in people selecting their own food.