Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study

Objectives Most previous research on plant-based diets and hypertension primarily focused on the general population, with limited data available among adults with type 2 diabetes (T2DM). Therefore, the present study was designed to investigate the association between plant-based dietary patterns and...

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Main Authors: Sina Naghshi, Maryam Saghafi-Asl, Elnaz Faramarzi, Sevil Kiani
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e088083.full
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author Sina Naghshi
Maryam Saghafi-Asl
Elnaz Faramarzi
Sevil Kiani
author_facet Sina Naghshi
Maryam Saghafi-Asl
Elnaz Faramarzi
Sevil Kiani
author_sort Sina Naghshi
collection DOAJ
description Objectives Most previous research on plant-based diets and hypertension primarily focused on the general population, with limited data available among adults with type 2 diabetes (T2DM). Therefore, the present study was designed to investigate the association between plant-based dietary patterns and hypertension among adults with T2DM.Design Cross-sectional study.Setting The AZAR cohort is part of the Persian Cohort, an Iranian screening programme, and includes participants who were residing in Shabestar county, East Azerbaijan Province, Iran for a minimum of 9 monthsParticipants A total of 1947 participants with T2DM were included in the current analysis.Outcome measures Hypertension was the outcome measure. This was defined as blood pressure ≥140/90 mm Hg, self-reported physician-diagnosed hypertension (supported by medical records) or use of antihypertensive medications.Results The mean age of the participants was 54.90±8.25 years, with 61% being female. The prevalence of hypertension among the participants was 48.6% (n=946). Adherence to plant-based diet index (PDI) showed a significant inverse association with hypertension in the crude model (OR: 0.60, 95% CI: 0.46 to 0.80, P-trend<0.001), but this association became non-significant after adjusting for confounders (OR: 0.88, 95% CI: 0.63 to 1.24, P-trend: 0.54). Moreover, healthful plant-based diet index displayed a significant positive association with hypertension in unadjusted analysis (OR: 2.03, 95% CI: 1.52 to 2.70, P-trend<0.001), which also disappeared after controlling for potential confounders (OR: 0.86, 95% CI: 0.61 to 1.21, P-trend: 0.35). However, no significant relationship was found between adherence to unhealthful plant-based diet index and hypertension in crude or fully adjusted models. Findings remained consistent across different subgroups, as well as sensitivity analyses.Conclusions The present study did not find a significant association between adherence to PDIs and hypertension in T2DM patients. Future studies are needed to investigate this association and to explore potential mechanisms linking plant-based dietary pattern with hypertension in diverse populations.
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spelling doaj-art-eb3a92916e004688bc519b72d2ae3e352025-08-20T02:49:36ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-088083Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional studySina Naghshi0Maryam Saghafi-Asl1Elnaz Faramarzi2Sevil Kiani3Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran1 Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of IranLiver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)1 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IranObjectives Most previous research on plant-based diets and hypertension primarily focused on the general population, with limited data available among adults with type 2 diabetes (T2DM). Therefore, the present study was designed to investigate the association between plant-based dietary patterns and hypertension among adults with T2DM.Design Cross-sectional study.Setting The AZAR cohort is part of the Persian Cohort, an Iranian screening programme, and includes participants who were residing in Shabestar county, East Azerbaijan Province, Iran for a minimum of 9 monthsParticipants A total of 1947 participants with T2DM were included in the current analysis.Outcome measures Hypertension was the outcome measure. This was defined as blood pressure ≥140/90 mm Hg, self-reported physician-diagnosed hypertension (supported by medical records) or use of antihypertensive medications.Results The mean age of the participants was 54.90±8.25 years, with 61% being female. The prevalence of hypertension among the participants was 48.6% (n=946). Adherence to plant-based diet index (PDI) showed a significant inverse association with hypertension in the crude model (OR: 0.60, 95% CI: 0.46 to 0.80, P-trend<0.001), but this association became non-significant after adjusting for confounders (OR: 0.88, 95% CI: 0.63 to 1.24, P-trend: 0.54). Moreover, healthful plant-based diet index displayed a significant positive association with hypertension in unadjusted analysis (OR: 2.03, 95% CI: 1.52 to 2.70, P-trend<0.001), which also disappeared after controlling for potential confounders (OR: 0.86, 95% CI: 0.61 to 1.21, P-trend: 0.35). However, no significant relationship was found between adherence to unhealthful plant-based diet index and hypertension in crude or fully adjusted models. Findings remained consistent across different subgroups, as well as sensitivity analyses.Conclusions The present study did not find a significant association between adherence to PDIs and hypertension in T2DM patients. Future studies are needed to investigate this association and to explore potential mechanisms linking plant-based dietary pattern with hypertension in diverse populations.https://bmjopen.bmj.com/content/15/3/e088083.full
spellingShingle Sina Naghshi
Maryam Saghafi-Asl
Elnaz Faramarzi
Sevil Kiani
Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
BMJ Open
title Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
title_full Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
title_fullStr Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
title_full_unstemmed Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
title_short Association between plant-based dietary patterns and hypertension among adults with type 2 diabetes in Azar cohort study in northwestern Iran: a cross-sectional study
title_sort association between plant based dietary patterns and hypertension among adults with type 2 diabetes in azar cohort study in northwestern iran a cross sectional study
url https://bmjopen.bmj.com/content/15/3/e088083.full
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