Hypertension Risk: Mediterranean Diet Study

By Nithya Somarapu on April 15, 2024

Mediterranean diet and hypertension risk study

Researchers evaluated the long-term effects of following the Mediterranean diet on the incidence of hypertension risk (HTN) over 20 years in a cohort of adults without hypertension in a recent study that was published in the European Journal of Clinical Nutrition.

Context

Hypertension Risk (HTN) has a substantial impact on global health, contributing to serious problems such as heart disease and stroke, which are particularly common in low- and middle-income nations. Although antihypertensive drugs help normalize blood pressure worldwide, over 30% of adults have hypertension (HTN), which increases the expenses and mortality associated with cardiovascular disease (CVD). To manage and prevent HTN, lifestyle changes like balanced diets, exercise, and stopping smoking are crucial. Diets rich in plant-based foods, low in alcohol and sodium, and high in lean proteins and healthy fats are recommended by health standards. More research is necessary since the Mediterranean diet, which has been linked to a lower risk of cardiovascular death and the prevention of chronic diseases since the 1960s, does not yet have conclusive long-term data supporting its ability to control blood pressure.

Concerning the study

Following the Declaration of Helsinki, the ATTICA project is a population-based, long-term health study that looks into the incidence of CVD in Greek people. 3,042 of the 4056 Attican invitees who were first invited gave their assent and were tracked for 20 years. The ATTICA study’s first phase, which ran from 2001 to 2002, featured in-person interviews with participants at their places of employment or residence. Trained medical professionals conducted these interviews, gathering extensive clinical, biochemical, and sociodemographic data according to a defined protocol. Several important parameters were measured, including total cholesterol (TC), high sensitivity C-reactive protein (hs-CRP), insulin, glucose, and fasting blood samples. Additionally, participants had physical exams to record their blood pressure and ensure there was no CVD. Lifestyle variables like food, exercise, and smoking were meticulously documented. A validated food frequency questionnaire was used to examine dietary patterns, and the MedDietScore was used to assess adherence to the Mediterranean diet.

Participants in the study were kept involved throughout 20 years via planned follow-ups, the most recent of which took place in 2022. In this most recent follow-up, 2169 of the initial participants were reassessed and information was gathered on their health outcomes, such as the emergence of diabetes, CVD, and HTN. Family reports and the deceased’s medical records were used to confirm information.

By analyzing baseline and 10-year eating patterns and finding four distinct trajectories of adherence to the Mediterranean diet, the study processed information using statistical software. After controlling for several confounders, including age, sex, body mass index (BMI), lifestyle choices, and baseline health condition, statistical analyses were performed to examine the relationship between dietary adherence and HTN risk. These tests included correlation coefficients, chi-squared tests, and logistic regression models.

Study findings

The study looked at the association between health and adherence to the Mediterranean diet over 20 years, following 1,415 adults. The mean age of the participants at baseline was 41 years, with a fairly equal gender distribution (44% men). With an average MedDietScore of 27.1, the population’s adherence to the Mediterranean diet was moderate. About half of the individuals were overweight or obese, and 63.1% of them engaged in only limited physical activity. Medical examinations showed that 3.9% of participants had diabetes and 35.3% of participants had hypercholesterolemia.

A strong negative association between systolic and diastolic blood pressure and adherence to the Mediterranean diet was found in the analysis of baseline data, indicating that stronger adherence to the diet was linked to lower blood pressure levels and reduced Hypertension Risk. 314 people experienced hypertension across the two-decade follow-up, representing a 22.2% incidence rate. In comparison to individuals who did not acquire hypertension, those who did so were often older, predominately male, and had higher rates of obesity, worse cardiometabolic profiles, and higher tobacco use.

Comprehensive research revealed a correlation between a higher incidence of hypertension and a lower baseline MedDietScore, highlighting the Hypertension Risk. In particular, individuals with poor diet adherence were much more likely to develop hypertension (HTN) than those with medium or high adherence. A 7% decrease in the chance of having HTN over 20 years was linked to every point rise in MedDietScore at baseline, according to statistical analysis. The inverse association between diet adherence and HTN risk persisted even after controlling for variables such age, gender, BMI, lifestyle choices, and preexisting medical conditions.

Different trends were seen when diet adherence trajectories from baseline to the 10-year mark were further examined. One important discovery was that individuals who continuously followed the Mediterranean diet (constantly close trajectory) had a significantly reduced incidence of hypertension than those whose adherence to the diet gradually declined. In the fully adjusted model, this group’s risk was 46.5% lower, demonstrating the long-term benefits of a Mediterranean diet in preventing hypertension.

For more information: Adherence to the Mediterranean diet and 20-year incidence of hypertension: the ATTICA prospective epidemiological study (2002–2022), European Journal of Clinical Nutrition, DOI: 10.1038/s41430-024-01440-w