| Title: | Dietary Patterns and Risk of Cardiovascular Disease and All-Cause Mortality in Adults with Untreated or Uncontrolled Hypertension |
| Journal: | Journal of Nutrition |
| Published: | 9 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42263942/ |
| DOI: | https://doi.org/10.1016/j.tjnut.2026.101659 |
Publication 20747
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Abstract
BACKGROUND: Although higher dietary quality scores for several established dietary indices have been consistently associated with lower risk of cardiovascular disease (CVD) and total mortality in the general population, limited evidence exists regarding their potential benefits among individuals with established hypertension.</p>
OBJECTIVES: The aims of this study were to examine the associations of dietary quality scores of multiple established dietary patterns with risks of incident CVD and all-cause death among adults with hypertension and to evaluate whether different dietary constructs exhibit heterogeneous prognostic relevance in this high-risk population.</p>
METHODS: We analyzed 83,248 UK Biobank participants with hypertension and no prior CVD at baseline. Diet quality was assessed using repeated 24-h recall questionnaires and scored according to 5 dietary indices: the Dietary Approaches to Stop Hypertension (DASH) score, the Alternative Healthy Eating Index-2010 (AHEI-2010), the Alternate Mediterranean Diet (AMED) score, the healthful Plant-Based Diet Index (hPDI), and the Empirical Dietary Inflammatory Pattern (EDIP). Each score was categorized into quintiles for analysis. The primary outcomes include a composite of nonfatal CVD events and cardiovascular death and all-cause mortality. Subgroup and interaction analyses were conducted across predefined clinical strata.</p>
RESULTS: During 1,230,983 person-years of follow-up, 4889 primary CVD events were documented. After adjustment for demographic and cardiovascular disease risk factors, compared with the lowest quintile, the highest quintile of the DASH score was associated with significantly lower CVD risk [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.77, 0.93], as was the reversed EDIP score (HR: 0.89; 95% CI: 0.81, 0.97). The AHEI-2010 score also showed a significant association (HR: 0.91; 95% CI: 0.83, 1.00), whereas the AMED (HR: 1.02; 95% CI: 0.93, 1.11) and hPDI (HR: 0.95; 95% CI: 0.86, 1.03) scores were not significantly associated with CVD risk. All 5 dietary scores were inversely associated with all-cause mortality (Q5 compared with Q1 HRs: 0.78-0.85; all P < 0.01), with the strongest association again observed for the DASH score. Food group-based analysis showed that higher intake of vegetables, whole grains, nuts and legumes, fruits, and dairy was significantly associated with lower CVD or mortality risk, whereas greater consumption of sugar-sweetened beverages and meats was significantly associated with higher risk (all P < 0.05).</p>
CONCLUSIONS: Among adults with hypertension, higher dietary quality scores of healthy dietary patterns, especially the DASH diet and reversed EDIP, were associated with lower risks of CVD and all-cause mortality.</p>
5 Authors
- Szu-Han Chen
- Binkai Liu
- Hao-Min Cheng
- Liming Liang
- Frank B Hu
1 Application
| Application ID | Title |
|---|---|
| 45052 | Genetic effect and genetic correlation among multiple related phenotypes and interaction with environmental exposures |
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