Objectives: Dietary treatment is appropriate for all patients with hypertension. However, only a few population-based studies have evaluated the diet of hypertensive individuals, and none of them has been conducted in Europe. This study examined accordance with the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet in the hypertensive population of Spain.
Methods: A cross-sectional study conducted in 2008-2010 among 12 948 individuals representative of the Spanish population aged at least 18 years. Blood pressure was measured with validated devices under standardized conditions. Habitual food consumption was assessed with a computerized diet history. DASH accordance was defined as at least 4.5 points on a score using nine nutrient targets, and Mediterranean diet accordance as at least 9 points on the Mediterranean Diet Adherence Screener score.
Results: Among the diagnosed hypertensive individuals, 17.3% [95% confidence interval (CI) 15.4-19.2%] had a DASH-accordant diet, and 17.2% (95% CI 15.4-19.1%) had a Mediterranean-accordant diet. The frequency of DASH accordance increased with age, was higher among women and hypercholesterolaemic individuals, and lower in current smokers. Similar results were found for Mediterranean diet accordance. Only 60% of the diagnosed hypertensive individuals reported receiving and following a diet prescribed to control hypertension; this group showed a better accordance with the DASH diet [age and sex-adjusted odds ratio (aOR) 1.43; 95% CI 1.08-1.88]. As compared with the 1518 hypertensive individuals unaware of their condition, those who were diagnosed showed a similar frequency of accordance with the DASH diet (aOR 1.08; 95% CI 0.87-1.34) and the Mediterranean diet (aOR 0.98; 95% CI 0.79-1.20).
Conclusion: The diet of hypertensive individuals in Spain has a low accordance with the DASH and Mediterranean dietary patterns. The similarity in healthy-diets accordance between the diagnosed and undiagnosed hypertensive individuals suggests that nutritional interventions in hypertensive patients are poor, a problem that should be compellingly addressed.