Inverse association between the Global Diet Quality Score and new-onset hypertension in adults: a nationwide cohort study.

BACKGROUND: The Global Diet Quality Score (GDQS) is a simple and practical dietary metric associated with many chronic diseases. Moreover, various foods related to blood pressure, especially diverse plant-based foods lowering blood pressure by improving vasodilation, are included. However, studies on the role of the GDQS in reducing the risk of new-onset hypertension and whether its performance is different from that of other dietary metrics are lacking.

OBJECTIVE: We aimed to examine the association between the GDQS and new-onset hypertension, and to compare its performance with that of other dietary patterns including the Plant-based Diet Index (PDI), alternate Mediterranean Diet (aMED) score, Alternative Healthy Eating Index-2010 (AHEI-2010), and Dietary Approaches to Stop Hypertension (DASH) score in Chinese adults.

METHODS: We included a total of 12, 002 participants (5644 men and 6358 women) aged >18 years from the China Health and Nutrition Survey (1997-2015). Dietary intake was estimated using average food intakes from 3 consecutive 24-h dietary recalls. Multivariable relative risks (RRs) were computed for hypertension using modified Poisson regression models.

RESULTS: With up to18 years of follow-up (average 8.7± 5.4 years), we ascertained 4232 incident cases of hypertension. Compared with participants with a low GDQS score (<15), the multivariable adjusted RR of hypertension was 0.72 (95%CI: 0.62-0.83) among participants with a high score (≥23). A 25-percentile increment in the GDQS was associated with a 30% (RR, 0.70; 95% CI, 0.64-0.76) lower risk of new-onset hypertension, which was comparable with the RRs of new-onset hypertension associated with per 25-percentile increment in the PDI (RR, 0.84; 95% CI, 0.76-0.93), DASH score (RR, 0.84; 95% CI, 0.78-0.91), and aMED score (RR, 0.89; 95% CI, 0.84-0.93).

CONCLUSION: A higher GDQS was associated with a lower risk of new-onset hypertension, with comparable associations of new-onset hypertension with PDI, DASH and aMED scores in Chinese adults.