The association between pro-inflammatory diet and incidence of hypertension: a prospective cohort study

Hypertension is a major public health challenge globally and in Iran. Given the role of inflammation in hypertension development, this study aimed to examine the association between the inflammatory potential of diet, quantified using the energy-adjusted Dietary Inflammatory Index (E-DII™), and the incidence of hypertension. The data of the present study were extracted from the Fasa Adult Cohort Study database. In this prospective cohort study, 10,138 participants were recruited at the baseline phase. Participants were contacted by telephone at regular intervals over 7 years. A selected group was also revisited after 5 years. Survival analysis was conducted to investigate the association between E-DII and hypertension incidence over a 7-year follow-up period, using Cox regression. Participants in the highest E-DII tertile (most pro-inflammatory diet) had a significantly higher risk for hypertension incidence during 7 years (HR_{T3 vs. T1} = 2.24, P value < 0.001). Moreover, the association of E-DII with hypertension incidence after 5 years was examined using logistic regression. Logistic regression revealed a significantly higher hypertension incidence after 5 years among participants in the highest E-DII tertile (OR_{T3 vs. T1} = 2.62, P value < 0.001). Linear regression showed positive and significant associations between E-DII and change in blood pressure components over 5 years. However, the associations in all models were attenuated and became statistically insignificant after adjustment for body mass index. Our findings indicate that consuming a pro-inflammatory diet was associated with an increased risk of developing hypertension. Moreover, body mass index emerged as a key covariate in this relationship.