Daily Almond Supplementation Improves Blood Pressure and Lipid Profile in Pregnant Women with Hypertension and Dyslipidemia: A Randomized Controlled Trial

Background: Hypertension and dyslipidemia during pregnancy increase risk of adverse maternal and fetal outcomes. Although almond supplementation is recognized for its cardioprotective effects in nonpregnant populations, its role during pregnancy remains underexplored despite its potential as a safe and accessible dietary intervention. Objectives: To evaluate the effects of almond supplementation at 2 doses (10 g/d and 25 g/d) on blood pressure, lipid profile, and heart rate in pregnant women with hypertension and dyslipidemia. Methods: This single-center, 12-wk randomized controlled trial enrolled 103 pregnant women (≥20 wk of gestation) with confirmed hypertension and/or dyslipidemia from Aga Khan Maternity Hospital, Karachi, with 46 participants meeting criteria for both conditions included in the primary analysis. Participants were randomly assigned into 3 groups: no-intervention (NI, control), 10 g/d almonds (A10), or 25 g/d almonds (A25). Primary outcomes were changes in systolic and diastolic blood pressure, measured every 4 wk. Secondary outcomes included serum triglycerides (TG), total cholesterol (TC), LDL, HDL, and heart rate, assessed at baseline and week 12. Data were analyzed using 1-way and 2-way repeated-measures analysis of variance with post hoc testing (P ≤ 0.05 considered significant). Results: At week 12, systolic blood pressure and diastolic blood pressure decreased significantly in both A10 (−13.7% and −5.8%) and A25 (−18.3% and −7.9%) compared with NI (−7.4% and −1.6%; P < 0.001). TC, TG, and LDL levels improved dose-dependently, with the A25 group showing the greatest reductions in TC (−22.5%), TG (−33.8%), and LDL (−27.3%) (P < 0.001). No significant differences were observed in HDL levels or heart rate across groups. Conclusions: Almond supplementation for 12 wk significantly improved blood pressure and lipid profile in pregnant women with hypertension and dyslipidemia, especially at the 25 g/d dose. These findings suggest that almonds may serve as an adjunct dietary strategy to manage cardiometabolic risk in pregnancy. Future trials with larger samples and longer durations are warranted to evaluate sustained benefits and long-term outcomes. Clinical trial registration: This trial is registered with the Australian New Zealand Clinical Trial Registry, ANZCTR, (registration number: ACTRN12617001548325) and can be accessed at https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370228&isReview=true. (Registration date: 10/11/2017).