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.