Association of plant-based food intake in daily diets and hypertension in Older Adults: A Cohort Study

Xiang Wang¹Ting Liu²Jianbang Shi¹Wei Jie¹Miao Dai^1*

• ¹Jiujiang First People's Hospital, Jiujiang, China
• ²Jiujiang Sixth People's Hospital, Jiujiang, China

Abstract Introduction: Hypertension is a major health concern among older adults, linked to high morbidity and mortality. While plant-based diets may offer health benefits, their association with hypertension in this population remains unclear. This study examines the relationship between plant-based food intake and hypertension incidence in older adults. Methods: We analyzed data from the Chinese Longitudinal Healthy Longevity Survey, including 3,991 hypertension-free participants aged ≥65 years at baseline (2008). Follow-up was conducted in 2011/2012. Plant-based diet intake was assessed using a plant-based diet index (PDI). Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for hypertension risk. Results: During a mean follow-up of 3.0 years, 1,764 individuals (44.2%) developed hypertension. Stratified by median PDI, the high PDI group had a 16% lower risk of hypertension versus the control group. Compared to the first quartile of PDI, the highest quartile had a lower risk of hypertension (HR 0.79, 95% CI: 0.69-0.90). The third and second quartiles of PDI had HRs of 0.79 (0.69-0.91) and 0.86 (0.76-0.98), respectively. Subgroup analyses indicated that the relationship between PDI and hypertension risk was not influenced by sex, gender, marital status, living arrangement, economic status, or activities of daily living limitations. Discussion: Higher adherence to a plant-based diet was significantly associated with a reduced risk of hypertension in older adults, suggesting that dietary interventions emphasizing plant-based foods may help mitigate hypertension incidence in this population.