In a recent study published in European Journal of Clinical Nutrition, Researchers evaluated the long-term impact of adherence to a Mediterranean diet on the incidence of high blood pressure (HTN) over a 20-year period in a cohort of nonhypertensive adults.

Study: Adherence to the Mediterranean diet and 20-year incidence of hypertension: ATTICA prospective epidemiological study (2002-2022).Image credit: Luigi Giordano

background

HTN has a significant impact on global health, causing serious complications such as heart disease and stroke, and is particularly prevalent in low- and middle-income countries. Despite effective antihypertensive drugs stabilizing global blood pressure levels, approximately 30% of adults suffer from her HTN, driving up cardiovascular disease (CVD)-related costs and mortality. I am. Lifestyle modifications such as a balanced diet, exercise, and smoking cessation are essential for the management and prevention of HTN. Health guidelines recommend a diet high in plant-based foods, healthy fats, and lean protein, and low in sodium and alcohol. The Mediterranean diet has been known since the 1960s to prevent chronic disease and reduce mortality from cardiovascular disease, but conclusive long-term evidence of its effectiveness in blood pressure control is lacking and further research is needed. is necessary.

About research

The ATTICA study, compliant with the Declaration of Helsinki, is a longitudinal population-based health study investigating CVD incidence among Greek adults. It started with his 4,056 invitees from Attica, 3,042 agreed, and was followed for 20 years. The initial phase of the ATTICA study, conducted in 2001-2002, involved face-to-face interviews at participants’ homes and workplaces. These interviews were conducted by trained health professionals who collected comprehensive sociodemographic, clinical, and biochemical data using a standardized protocol. Key measurements include fasting blood samples to assess blood sugar, insulin, total cholesterol (TC) levels, high-sensitivity C-reactive protein (hsCRP), and more. Participants also underwent a physical examination to ensure the absence of CVD and to record blood pressure. Lifestyle factors such as diet, physical activity, and smoking habits were carefully recorded, dietary patterns were assessed using a validated food frequency questionnaire, and adherence to the Mediterranean diet was assessed by his MedDietScore.

The study continued to engage participants through regular follow-up visits over a 20-year period, with the most recent follow-up conducted in 2022. This latest follow-up study re-evaluated the original 2,169 participants and collected data on health outcomes, including developmental disorders. It causes HTN, diabetes, and CVD. Information was confirmed by family reports and medical records of the deceased.

The study used statistical software to analyze data, compare baseline and 10-year dietary patterns, and identify four distinct trajectories of adherence to the Mediterranean diet. Statistical analysis included correlation coefficients to examine the association between dietary adherence and HTN risk, adjusting for multiple confounders such as age, gender, body mass index (BMI), lifestyle, and baseline health status. , chi-square tests, and logistic regression models. .

research result

The study followed 1,415 participants over 20 years to examine the relationship between adherence to a Mediterranean diet and health. At baseline, participants’ mean age was 41 years, with an approximately even distribution across gender (44% male). The population showed moderate adherence to the Mediterranean diet, with a mean MedDietScore of 27.1. Physically, 63.1% of the subjects were minimally active, and about half were overweight or obese. Medical evaluation revealed a prevalence of hypercholesterolemia in 35.3% and diabetes in 3.9% of participants.

Analysis of baseline data shows a clear negative correlation between adherence to the Mediterranean diet and systolic and diastolic blood pressure, suggesting that higher adherence is associated with lower blood pressure levels. it was done. During the 20-year follow-up, 314 people developed hypertension, giving an incidence of 22.2%. Those who developed hypertension were generally older, primarily male, had higher rates of obesity, a worse cardiometabolic profile, and smoked more than those who did not develop HTN.

Further analysis showed that lower baseline MedDietScore was associated with higher incidence of hypertension. Specifically, participants with low dietary adherence had a significantly higher incidence of HTN compared to participants with medium or high dietary adherence. Statistical analysis confirmed that each point increase in his MedDietScore at baseline was associated with a 7% reduction in his risk of developing HTN over 20 years. Even after adjusting for factors such as age, gender, BMI, lifestyle, and baseline health status, the inverse association between dietary adherence and her risk of HTN remained significant.

Further examination of dietary adherence trajectories from baseline to year 10 revealed diverse patterns. A key finding was that participants who consistently adhered to the Mediterranean diet (always on a close trajectory) had significantly lower rates of HTN compared to participants whose adherence weakened over time. is. This group had a 46.5% lower risk in the fully adjusted model, highlighting the protective effect of continued adherence to a Mediterranean diet against his HTN.