Abstract Body: Introduction: Healthy dietary patterns have been consistently linked to lower risks of cardiovascular disease (CVD) and mortality in the general population. However, evidence among individuals with established hypertension remains limited.
Hypothesis: We hypothesized that higher adherence to healthy dietary patterns are associated with lower risks of incident CVD and all-cause death among adults with hypertension.
Methods: We analyzed participants with hypertension and no prior CVD from the UK Biobank. Diet quality was assessed using 24-hour dietary recall questionnaires. Five versions of dietary indices were calculated: 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) index. Multivariable-adjusted Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between each index and outcomes.
Results: During 1,230,983 person-years of follow-up in 83,248 participants with hypertension, 4,889 CVD events and 8,276 deaths occurred. Compared with the lowest quintile, the highest quintile of DASH adherence was associated with lower CVD risk (HR 0.85, 95% CI 0.77–0.93, p for trend = 0.003), as was a lower inflammatory diet (reversed EDIP; HR 0.89, 0.81–0.97 , p for trend = 0.009). AHEI-2010 showed a borderline association (HR 0.91, 0.83–1.00, p for trend = 0.062), while AMED and hPDI were not significant. All five dietary scores were inversely associated with all-cause mortality (HRs 0.77–0.85; all P for trend < 0.01). The foods that were associated with lower mortality include vegetables, whole grains, nuts and legumes, fruits, and vegetable oil, while foods associated with increased CVD risk or mortality include sugar sweetened beverage and red meat.
Conclusions: Among adults with hypertension, adherence to healthy dietary patterns—especially the DASH and low-inflammatory diets—was associated with lower risks of CVD and all-cause mortality.