Dietary modulation for the hypertension risk group in Koreans: a cross-sectional study

Background Hypertension (HTN) is a critical global health issue, contributing to high morbidity and mortality rates. Representative risk factors for HTN include aging, genetics, obesity, alcohol drinking, smoking, and diet. Dietary interventions like the Dietary Approaches to Stop HTN (DASH) diet plan effectively prevent and manage HTN. We intend to evaluate the influence of eating patterns on HTN, applying multiple risk factors. Methods For cross-sectional design, study subjects were grouped into four groups: optimal (n = 7,712), normal (n = 1,220), high normal (n = 3,655), and HTN (n = 4,355) according to the 2022 HTN treatment guidelines of Korea. Factor analysis was performed to identify major dietary patterns based on nutritional data obtained from a brief dietary questionnaire, including 17 food items. Finally, we conducted a moderation analysis to evaluate the impact of dietary patterns on the HTN risk score, which is determined by genetic variables, body mass index, alcohol consumption, and smoking status. Results We identified three principal dietary patterns (Korean, Western, and New diet) in the study population. Adherence to the New diet was linked to lower HTN risk in all models (p < 0.001), while the Western and Korean diets were associated with a higher risk of HTN in some models. In high HTN-risk individuals, adherence to the Western diet increased the HTN risk trend (p < 0.001), whereas the New diet showed a potential protective trend (p = 0.059). Conclusions The nutritional moderation effect was evident in the HTN high-risk group, where the Western diet increased risk, while the New diet showed a borderline protective effect. If the findings are validated by longitudinal investigation, our findings could serve as the basis for developing dietary guidelines for HTN.