Abstract

Objective: This study assessed the relationship of dietary patterns (derived from the frequency of food consumption) with hypertension among stroke-free controls recruited from Nigeria and Ghana in the Stroke Investigation Research and Educational Network (SIREN) study. Design and Methods: This study was a matched case-control study with 1500 hypertensives randomly selected and matched for the country of residence, age and sex with 1500 normotensives in the SIREN study. Factor analysis using principal component analysis was used to summarise food information and seven dietary patterns (DP); vegetables, poultry product and organ meat, whole-grain and fruit drinks, fried foods and sweetened drinks, red meat, processed foods and fruits were identified. Hypertension was defined as one of the following conditions; systolic blood pressure of 140mmHg/greater or diastolic blood pressure of 90mmHg/greater or previous diagnosis or use of antihypertensive medications. Multivariable adjusted logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for hypertension by the median of factors scores in each DP (adjusting for age, education, income, smoking, alcohol use, physical inactivity, family history of cardiovascular diseases and obesity) at a two-sided P < 0.05. Results: Mean age was 56.2 ± 13.5years and multivariable-adjusted OR (95%CI) for odds of hypertension by the median (with < median of factor score as reference) of DPs revealed higher consumption of whole grains and fruit drinks; 0.83 (0.73, 0.96; P = 0.01) was associated with lower odds of hypertension, but higher consumption of processed foods; 1.18 (1.00, 1.40; P = 0.04) was associated with higher odds of hypertension. Furthermore, multivariable-adjusted OR (95%CI) of hypertension for other DPs include; 0.88 (0.74, 1.04; P = 0.13) for vegetables; 0.89 (0.75, 1.05; P = 0.16) for poultry product and organ meat; 0.90 (0.76, 1.06; P = 0.21) for fruits; 0.90 (0.77, 1.07; P = 0.23) for fried foods and sweetened drinks and 1.03 (0.87, 1.21; P = 0.76) for red meat. Conclusion: Diet rich in whole grains was associated with lower hypertension risk, but higher consumption of processed foods was related to a deleterious hypertension risk. Also, higher consumption of plant-based diets presented a suggestive inverse relationship with hypertension, but diets dense with red meat presented a suggestive deleterious hypertension risk.

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