Association of dietary patterns with all-cause and cause-specific mortality in a high cardiovascular risk population...

This study investigated dietary patterns among populations at high risk for cardiovascular disease (CVD) in Hunan Province and examined their associations with mortality.

Data were obtained from the China Health Evaluation and Risk Reduction through Nationwide Teamwork (ChinaHEART) project conducted between 2014 and 2023. A total of 46,239 individuals aged 35-75 years at high risk for CVD were included in the analysis. Major dietary patterns were identified using exploratory factor analysis with principal components analysis and Varimax rotation. Factor scores were calculated using the regression method. Each participant was then assigned to the dietary pattern with the highest score, and adherence to each pattern was further evaluated by quartiles of factor scores (Q1-Q4). Cox proportional hazards regression models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with sequential adjustment for demographic characteristics, lifestyle factors, and cardiometabolic conditions.

During a median follow-up of 45 months (range: 3-81 months), 792 all-cause deaths were recorded among 46,239 participants. Compared with the "Rice Pattern", greater adherence to the "Meat, Eggs, and Fresh Vegetables Pattern" was associated with lower risks of all-cause mortality (HR = 0.64, 95% CI: 0.50-0.82; P < 0.001) and chronic cardiovascular disease mortality (HR = 0.44, 95% CI: 0.24-0.77; P < 0.01). Similar patterns of association were observed in subgroup analyses and were generally consistent in sensitivity analyses.

These findings provide evidence-based support for dietary guidance in high-risk populations and have important implications for the prevention and management of cardiovascular disease.