Mediterranean diet reduces CV risk in antihypertensive drug users

Following a Mediterranean diet lowers the risk of initiating or increasing antihypertensive medication in an older population at high cardiovascular (CV) risk and reduces CV risk among antihypertensive drug users, suggest the results of the PREvención con DIeta MEDiterránea study.

The authors determined whether volunteers randomized to an intervention with a Mediterranean diet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, disclosed differences in the risk of initiating antihypertensive medication in nonusers at baseline (n=2,188) and escalating therapy in those using one (n=2,361), two (n=1,579), or three drugs (n=554) at baseline.

In addition, the authors sought to determine whether allocation to Mediterranean diet modified the relation between antihypertensive drug use and incident CV events.

Individuals assigned to Mediterranean diet interventions had a lower risk of initiating antihypertensive therapy (5-year incidence rates: 43.0 percent in the Mediterranean diet vs 47.1 percent in the control diet; hazard ratio [HR], 0.84, 95 percent confidence interval [CI], 0.74–0.97, in a model adjusted for age, sex, and recruitment site).

Participants on two antihypertensive drugs at baseline in the Mediterranean diet intervention enriched with extra-virgin olive oil showed a reduced risk of therapy escalation relative to those in the control diet (5-year incidence rates: 20.1 percent vs 22.9 percent; HR, 0.77, 95 percent CI, 0.60–0.99).

In addition, the Mediterranean diet intervention attenuated the association between antihypertensive therapy at baseline and incidence of major adverse CV events (p_interaction=0.003).