Associations between Dietary Patterns and Self-Reported Hypertension among Brazilian Adults: A Cross-Sectional Population-Based Study

Abstract Hypertension is a prevalent cardiovascular disease, the important modifiable risk factor of which is diet. The aim of this study was to derive dietary patterns and to test associations with self-reported hypertension and other characteristics, namely demographic, socioeconomic, and lifestyle factors. Data were obtained from the population-based cross-sectional study titled Health Survey of the City of Sao Paulo, with a random sample of residents of the city of Sao Paulo, Brazil, aged older than 20 years of both sexes (n=1,102). In 2008, a structured questionnaire with information about socioeconomic, anthropometric, lifestyle, and dietary factors was applied. Dietary intake was estimated by two 24-hour dietary recalls, adjusted by Multiple Source Method. Dietary patterns were obtained through exploratory principal component factor analysis. Poisson regression was used to assess relationships. Three dietary patterns were identified: prudent (fruits, vegetables, whole-grain bread, white cheeses, juices, reduced-fat milk/nonfat milk), traditional (rice, beans, bread/toast/crackers, butter/margarine, whole milk, coffee/teas, sugar), and modern (sodas, pastries/sandwiches/pizzas, yellow cheeses, pastas, sauces, alcoholic beverages, sweets, processed meats). Hypertension and demographic, socioeconomic, and lifestyle factors, as well as the presence of health insurance, were associated with adherence to one or more identified dietary patterns. These results suggest the existence of a target audience for planning and executing public policies of food and nutrition to prevent and control hypertension.