A comprehensive analysis of fruit, vegetable, and legume consumption and the risk of hypertension: results from the KoGES_CAVAS cohort

Purpose: This study aimed to investigate the association between total consumption of fruits (F), vegetables (V), and legumes (L) and their subgroups and hypertension risk in adults aged ≥ 40 years in the Cardiovascular Disease Association Study (CAVAS). Methods: We analyzed data from 10,325 normotensive participants using cumulative average dietary consumption from repeated food frequency questionnaires during the follow-up. Incidence rate ratios (IRRs) were estimated with a modified Poisson regression model and a robust error estimator to evaluate the association between hypertension risk and total consumption of fruits, vegetables, and legumes, as well as their 17 subgroups. Results: During an average follow-up of 5.20 years, 2159 cases of hypertension were recorded. Total consumption of FVL, FV, fruits, vegetables, and legumes showed overall inverse trends with hypertension risk. Considering multiplicity, fruit consumption was inversely associated with hypertension risk in both men (IRR 0.64; 95% CI 0.52–0.79) and women (IRR 0.76; 95% CI 0.64–0.91). Vegetables were inversely associated with hypertension in women (IRR 0.67; 95% CI 0.53–0.86). Most subgroups showed inverse associations, especially in men with overweight/obesity. However, frequent pickled green leafy vegetable consumption was positively associated with hypertension risk in postmenopausal women but not in premenopausal women (P_interaction = 0.0004). Conclusion: Consumption of FVL, including their subgroups, generally shows inverse associations with hypertension risk. However, caution is advised for recommending pickled vegetables, particularly for postmenopausal women, due to the potential adverse effects of sodium. The benefits of these foods in preventing hypertension are especially pronounced in men with overweight/obesity.