Effects of dietary patterns on the all-cause mortality and cardiovascular disease mortality in patients with hypertension: A cohort study based on the NHANES database.

Abstract

Hypertension (HTN) patients have higher risk of all-cause and cardiovascular disease (CVD)-specific mortality. Dietary patterns have been reported related to the risk of mortality, but their roles in HTN patients is unclear. To explore the relationships between different dietary patterns and all-cause/CVD-specific mortality and provide dietary guidance for HTN patients'prognosis improvement. Data of 27 618 HTN patients were extracted from the National Health and Nutrition Examination Survey(NHANES) database in this retrospective cohort study. The associations between Healthy Eating Index (HEI)-2015, Alternate Healthy Eating Index(AHEI)-2010, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean(MED) diet and all-cause and CVD-specific mortality were explored using univariate and multivariate Cox regression analyses with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, gender, body mass index, and comorbidity were also performed. The median follow-up time was 83 months. A total of 3462 patients died for all-cause and 1064 died due to CVD. After adjusting for covariates, we found that high adherence to AHEI-2010 (HR = 0.84 for all-cause; HR = 0.72 for CVD), and MED (HR = 0.84 for all-cause; HR = 0.77 for CVD) diet were associated with decreased risks of both all-cause and CVD-specific mortality. In patients who aged ≥65 years old, were normal/overweight, without complications, therelationships between different dietary patterns and risk of mortality were different. High scores of AHEI-2010 and MED may be associated with decreased risks of all-cause and CVD-specific mortality in patients with HTN.