Abstract
BackgroundHypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension.MethodsThis study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs.ResultsHypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension.ConclusionsAdhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.
Highlights
Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD)
For women with hypertension compared with those with normal blood pressure, the frequency distribution of individuals in terms of history of diabetes, alcohol consumption, active smoking, taking supplements, and history of ischemic heart disease were significantly lower in women with hypetension compared with women with normal BP
The findings revealed that people in the highest quartile of Mediterranean dietary score (MDS) and healthy eating index-2015 (HEI2015), compared with individuals in the lowest quartile, had significantly lower odds for having hypertension, but, no such relationship was observed for diet quality index-international (DQI-I) and dietary diversity score (DDS)
Summary
Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Excessive consumption of dietary sodium, saturated fatty acids, cholesterol, and alcohol are shown to be linked to an elevated risk of hypertension, while intake of vegetables/fruits and foods rich in magnesium, calcium, potassium, and unsaturated fatty acids is reported to reduce blood pressure [5, 11]. Evidence shows that higher diet quality assessed by other a priori dietary indices, including the Mediterranean dietary score (MDS), diet quality index-international (DQI-I), healthy eating index-2015 (HEI-2015), and dietary diversity score (DDS) are protective against the risk of CVD [19,20,21,22]. The relation of these indices to hypertension is not well-established
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