Abstract
Background: Diet plays a vital role in the incidence of hypertension. Considering the complex composition and proportion of the diet and changes in eating habits, therefore, this study explores the association between the trajectory of dietary patterns and hypertension. Methods: A total of 1234 adults without hypertension at baseline and who provided at least three survey data from 1997 to 2018 were included. Factor analysis was used to extract dietary patterns, whose trajectories were simulated using the group-based trajectory model. The Cox proportional hazards regression model was used to analyze the association between dietary pattern trajectories and hypertension. Results: The factor analysis indicated four dietary patterns: the southern pattern, rice-vegetarian pattern, healthy pattern, and alcohol-meat pattern. Compared to the low-rapid rise and medium-stable groups of the southern pattern, participants in the high-stable group had a 20% reduction in the risk of hypertension (HR: 0.80; 95% CI: 0.67-0.96). The high-rapid rise group of the healthy pattern exhibited a 42% reduction in hypertension risk (HR: 0.58; 95% CI: 0.35-0.97). Conversely, individuals in the medium-high-medium subgroup of the alcohol-meat pattern displayed an increased risk of hypertension compared to those in the low-stable subgroup, with an HR of 1.48 (95% CI: 1.13, 1.94). No significant association was found between the rice-vegetarian pattern trajectory and hypertension (HR: 1.06; 95% CI: 0.85-1.34). Conclusions: Long-term adherence to the southern and healthy patterns might reduce the risk of hypertension, but following the alcohol-meat pattern might increase the risk of hypertension among adults in China.