Groceries for Black Residents of Boston to Stop Hypertension Among Adults Without Treated Hypertension

INCLUSION:

• Self-reported/self-identified as Black or African American

• Resting systolic blood pressure of 120 to <150 mm Hg and diastolic blood pressure <100 mm Hg

• Residence in communities identified as Boston area food deserts: Brighton, Chelsea, Dorchester, East Boston, Everett, Hyde Park, Jamaica Plain, Malden, Mattapan, Revere, Roslindale, Roxbury, or Winthrop

• Able to receive home-delivered groceries or pick them up at a convenient location and willing to eat only the groceries provided over a 12-week period

• Have access to refrigeration, cooking appliances, and Wi-Fi/cellular service

• Have access to mobile device or computer to be able to conduct grocery orders via video conference or by phone

• Willing and able to complete required measurement procedures

EXCLUSION:

Laboratory Exclusions:

• Serum potassium ≥5.0 mmol/L or <3.5 mmol/L

• Estimated glomerular filtration rate (eGFR) <30 mL/min per 1.73 m^2 by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation

• Hemoglobin A1c ≥6.5%

Medication Exclusions:

• Any use of medications that lower blood pressure or medications intended for hypertension treatment (including antihypertensives taken for non-hypertension purposes) within the last 6 months

• Unstable doses (i.e. a change in the 2 months prior to screening or randomization) of the following:

• Sodium-glucose co-transporter 2 (SGLT2) inhibitors

• Stimulants

• Inhaled or oral medications for asthma or chronic obstructive pulmonary disease (COPD)

• Hormone replacement therapy or thyroid hormone

• Weight-increasing psychotropic agents, including antipsychotic agents, lithium, and mirtazapine

• Use of any of the following medications:

• Potassium supplement, except if part of a multivitamin

• Warfarin (Coumadin)

• Chronic oral corticosteroid (intermittent use is okay)

• Weight loss medications (including GLP-1 receptor agonists)

• Unwillingness to keep same dose of vitamin, mineral, and botanical supplements

• Any medication not compatible with participation as determined by the investigators

Physical Exclusions:

• Systolic blood pressure ≥150 mm Hg or diastolic blood pressure ≥100 mm Hg

• Body weight >420 pounds

• Arm circumference >50cm

• Weight loss or gain of >5.0% of body weight during prior 2 months

Medical History Exclusions:

• Type 1 or Type 2 Diabetes defined as a hemoglobin A1c ≥6.5% or diabetes treatment

• Active cardiovascular disease or any event in the prior 6 months, including coronary artery bypass grafting (CABG), percutaneous transluminal coronary angioplasty (PTCA), myocardial infarction (MI), cerebrovascular accident (CVA), or congestive heart failure (CHF) exacerbation requiring hospital admission

• Cancer diagnosis or treatment in the last 2 years (non-melanoma skin cancer or localized breast or prostate or bladder cancer not requiring systemic therapy is acceptable)

• Active inflammatory bowel disease, bowel resection, malabsorptive syndrome, pancreatitis (episode within past year), or history of bariatric surgery

• Pregnancy or lactation or planned pregnancy

• Any emergency department (ED) visit for asthma or chronic obstructive pulmonary disease (COPD) in the last 6 months

• Any other serious illness or condition not compatible with participation as determined by the investigators

Lifestyle and Other Exclusions:

• Significant food allergies, preferences, intolerances, or dietary requirements that would interfere with diet adherence

• Consumption of more than 14 alcoholic drinks per week or consumption of more than 6 drinks on one or more occasion per week

• Active substance use disorder that would interfere with participation

• Extreme food insecurity

• Participation in or planning to start weight loss program

• Current participation in another clinical trial that could interfere with the study protocol

• Anticipated change in residence prior to the end of the study

• Families with more than 6 adults at dinner time (children are considered to be half an adult)

• Investigator discretion