Key Points
- A structured, home-delivered DASH-aligned grocery program significantly reduced systolic blood pressure (SBP) compared with financial assistance alone among African American adults with hypertension
- The intervention also improved LDL cholesterol and diastolic blood pressure (DBP), with effects persisting after program completion.
- Nutrient-targeted grocery ordering appears to be a useful strategy to improve longer-term cardiometabolic health.
Hypertension (HTN) disproportionately affects African- American adults in the United States, with structural barriers such as limited access to healthy foods contributing to poor control. While the DASH (Dietary Approaches to Stop Hypertension) diet is well established to reduce blood pressure, translating this intervention into real-world settings, especially among patients already receiving treatment, has been challenging. The GoFreshRx trial was designed to evaluate whether a structured grocery delivery program could bridge this gap and improve cardiometabolic outcomes. The main results were presented at ACC 2026 with simultaneous publication in Nature Medicine
GoFreshRx was a randomized, parallel-group clinical trial (ClinicalTrials.gov: NCT05121337) conducted in Boston. A total of 176 African American adults with treated HTN (SBP 120-149 mm Hg) living in low-access food environments were randomized 1:1 to: 1) weekly home-delivered DASH-patterned groceries with dietitian counseling, or 2) a grocery stipend plus standard educational materials. The primary endpoint was change in systolic blood pressure (SBP) at 3 months, with secondary endpoints including diastolic BP (DBP) and LDL-C.
At 3 months, the intervention group experienced a significantly greater reduction in SBP compared with the control group (-7.0 mm Hg vs. -2.0 mm Hg; between-group difference -5.0 mm Hg; p=0.002). Secondary outcomes also favored the intervention, including greater reductions in DBP and LDL-C. Notably, these improvements were sustained three months after cessation of the intervention, suggesting durable behavioral or environmental effects.
Participants were predominantly older (mean age 60 years) and female, representing a population at elevated cardiovascular risk. The intervention’s magnitude of effect is comparable to that seen with some pharmacologic therapies, underscoring its clinical relevance.
GoFreshRx provides compelling evidence that addressing social determinants of health, specifically food access, can yield meaningful improvements in cardiovascular risk factors. Unlike prior dietary trials, this study focused on individuals already receiving antihypertensive therapy, demonstrating additive benefit beyond medications. However, limitations include its relatively short duration and single-city design, which may affect generalizability and scalability, particularly in rural settings. The investigators note future studies should evaluate long-term outcomes, cost-effectiveness, and broader implementation strategies. Even so, the overall results led lead investigator Stephen Paul Juraschek to remark: “We’re very excited by the magnitude of the effects – it’s really above and beyond what we anticipated.”