Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies

Abstract

Purpose A high fruit and vegetable intake has been associated with reduced risk of hypertension; however, results have been inconsistent and it is unclear whether specific types of fruits and vegetables are particularly beneficial. This systematic review and meta-analysis aimed to summarize the published prospective studies on fruit and vegetable consumption and risk of hypertension. Methods Embase and PubMed databases were searched for relevant prospective studies up to 15th May 2022. Random effects models were used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between fruit and vegetable intake and risk of hypertension. Strength of evidence was assessed using World Cancer Research Fund (WCRF) criteria. Results Eighteen prospective studies (451 291 participants, 145 492 cases) were included. The summary RR (95% CI) of hypertension per 200 g/day was 0.97 (0.95–0.99, I2 = 68%, n = 8) for fruits and vegetables, 0.93 (0.89–0.98, I2 = 77%, n = 10) for fruits, and 1.00 (0.98–1.02, I2 = 38%, n = 10) for vegetables. Reductions in risk were observed up to 800 g/day for fruits and vegetables, and 550 g/day for fruits, and these two associations were considered probably causal using WCRF criteria. Inverse associations were observed for apples or pears, blueberries, raisins or grapes, avocado, broccoli, carrots and lettuce, while positive associations were observed for cantaloupe, Brussels sprouts, cruciferous vegetables, and total and fried potatoes (n = 2–5). Conclusion A high intake of fruit and vegetables combined, and total fruit was associated with reduced risk of hypertension, while results for fruit and vegetable subtypes were mixed and need further study.

Assessing body mass index stages, individual diabetes and hypertension history effects on the risk of developing hypertension among Ghanaians: A cross‐sectional study

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Dietary patterns associated with hypertension among stroke-free indigenous Africans: insights from the Stroke Investigative Research and Educational Network study

“…It is worth noting that several large studies [56–58] have extensively documented the protective effect of fruits and vegetables against CVD, and our findings support this association. However, a recent meta-analysis of 18 cohort studies reported that high consumption of fruits and vegetables, and not vegetables alone [59], was beneficial. The beneficial effect of a diet rich in plant food sources might be apparent with an increase in magnitude and variety of consumption, given that another review of randomized trials has documented no robust beneficial evidence for lowered blood pressure in the light of the consumption of a single type of fruit or vegetable [60].…”

Associations of Dietary Intake with Cardiovascular Risk in Long-Term “Plant-Based Eaters”: A Secondary Analysis of a Cross-Sectional Study

“…Whole grains, legumes, fruits, vegetables, and nuts/seeds consistently show protective effects against CVDs. These foods are packed with fiber, which can help to reduce cholesterol levels, lower blood pressure, and improve blood sugar control [ 19 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. It is essential to understand that not all plant-based diets are the same.…”