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Diet behaviours and hypertension in US adults

the National Health and Nutrition Examination Survey 2013–2014

Zhou, Longa,*; Feng, Yanga,*; Yang, Yuxuanb; Zhao, Xiaodanb; Fan, Yamenga; Rong, Jiea; Liu, Danc; Zhao, Lianchengd; Yu, Yana

doi: 10.1097/HJH.0000000000002037

Objective: The present study aims to explore the association between ideal diet behaviours recommended by the American Heart Association (AHA) and hypertension in the United States (US) adults using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2014.

Methods: Whole grains, fruits and vegetables, fish, sodium and sugar-sweetened beverages at an ideal level were defined as the AHA's recommendation. Associations between number of ideal diet behaviours and hypertension were assessed through multivariate logistic regression models.

Results: A total of 4462 US adult participants (2110 men and 2352 women) were included in the analysis, of whom 1516 (34.0%) were diagnosed with hypertension. The multivariate adjusted odds ratios and 95% confidence intervals (95% CIs) for hypertension in the groups with one, two and at least three ideal diet behaviours were 0.88 (0.71–1.10), 0.89 (0.70–1.12) and 0.67 (0.49–0.91), when the group with 0 ideal diet behaviour was used as the reference. Results also showed that women with three or more ideal diet behaviours had 43% (95% CI: 10–64%) lower odds of hypertension.

Conclusion: The number of diet behaviours at the ideal level recommended by the AHA was inversely associated with hypertension in US adults.

aSchool of Public Health, Xi’an Jiaotong University Health Science Center

bXi’an Jiaotong University Health Science Center, Xi’an, China

cPopulation Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany

dDivision of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Correspondence to Professor Yan Yu, School of Public Health, Xi’an Jiaotong University Health Science Center, 76# West Yanta Road, Xi’an 710061, China. Tel: +86 13085706658; fax: +86 029 82655111; e-mail:

Abbreviations: AHA, american heart association; BP, blood pressure; CI, confidence interval; CVD, cardiovascular disease; DASH, Dietary Approaches to Stop Hypertension; FBG, fasting blood glucose; HPFS, Health Professionals Follow-Up Study; INTERMAP, International Study of Macro-/Micro-nutrients and Blood Pressure; JHS, Jackson Heart Study; NCHS, National Center for Health Statistics; NHANES, National Health and Nutrition Examination Survey; OR, odds ratio; RR, relative risk; SSBs, sugar-sweetened beverages; TC, total cholesterol; US, United States

Received 21 October, 2018

Revised 6 December, 2018

Accepted 6 December, 2018

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