Relationship Between Diet Quality and Antihypertensive Medication Intensity Among Adults With Metabolic Syndrome-Associated High Blood Pressure

Abstract

BackgroundManagement of high blood pressure (BP), a key feature of the metabolic syndrome (MetS), relies on diet and medication. Whether these modalities are used as complements has never been evaluated in real-world settings. This study assessed the relationship between diet quality and antihypertensive medication intensity among adults with MetS-associated high BP. MethodsThis cross-sectional study included 915 adults with MetS-associated high BP from the CARTaGENE cohort (Québec, Canada), of whom 677 reported using BP-lowering medication. Antihypertensive medication intensity was graded per the number of BP-lowering classes used simultaneously. Diet quality was assessed using the Dietary Approach to Stop Hypertension (DASH) score. ResultsNo evidence of a relationship between antihypertensive medication intensity and diet quality was found (β for each additional antihypertensive = –0.05; 95% CI, –0.35; 0.26 DASH score points). However, among men aged < 50 years and women aged < 60 years, the DASH score was inversely associated with medication intensity (β = –0.72; 95% CI, –1.24, –0.19), whereas this relationship tended to be positive among older participants (β = 0.32; 95% CI, –0.05, 0.69). Among participants with low Framingham risk score, the DASH score was inversely associated with medication intensity (β = –0.70; 95% CI, –1.31, –0.09), but no evidence of an association was found among individuals at moderate (β = 0.00; 95% CI, –0.45, 0.45) or high (β = 0.30, 95% CI, –0.24, 0.84) risk. ConclusionsIn this cohort of adults with MetS-associated high BP, there was an overall lack of complementarity between diet quality and BP-lowering medication, especially among younger individuals and those with a lower risk for cardiovascular disease for whom diet quality was inversely associated with intensity of medication.