Healthy Eating Index 2015 and Major Dietary Patterns in Relation to Incident Hypertension; A Prospective Cohort Study

Background: Since hypertension (HTN) is responsible for more than half of all deaths from cardiovascular disease, it is important to know the nutritional factors that reduce its risk. Although little information is known about it in the Kurdish population. This study was aimed to evaluate healthy eating index (HEI) 2015 and major dietary patterns in relation to incident HTN. Methods: : This case- cohort study was designed using data from Ravansar non- communicable diseases (RaNCD) cohort study (294 participants with incident HTN and 1295 participants as representative random sub-cohort). HEI 2015 and major dietary patterns were extracted using data from their dietary intake and three major dietary patterns were identified including plant- based, high protein, and unhealthy dietary patterns. To analysis of association between HEI 2015 and major dietary patterns with incident HTN Cox proportional hazards regression models were applied. Results: : There was a positive significant correlation between HEI 2015 and plant- based diet (r=0.492). The participants in the highest quartile of HEI-2015 had a 39% lower risk of incident HTN, compared to participants in first quartile in both crude and adjusted model (HR: 0.61; 95% CI: 0.46-0.82) and (HR: 0.7; 95% CI: 0.51–0.97), respectively. Furthermore, participants who were the highest tertile of plant- based dietary pattern were lower risk of incident HTN in both crude and adjusted models (HR: 0.69; 95% CI: 0.54–0.9) and (HR: 0.7; 95% CI: 0.53–0.94), respectively. However, other two identified dietary patterns had no significant association with incident HTN. Conclusions: : We found evidence indicating higher adherence to HEI 2015 and plant- based diet had protective effects on incident HTN. The HEI 2015 emphasizes limited sodium intake and adequate intake of vegetables and fruits.