Association of Fruit and Vegetable Intake with All-Cause and Cardiovascular Mortality Among Hypertension Populations in China: A Cohort Study
1
National Center for Chronic and Noncommunicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, China
2
Department of Big Data in Health Science, and Center for Clinical Big Data and Statistics, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
Popul. Med. 2026;8(Supplement Supplement 1):A106
ABSTRACT
BACKGROUND:
Previous studies have shown that fruit and vegetable intake was associated with a reduced risk of mortality. But evidence is limited among Chinese hypertension patients. This study explores the association of fruit and vegetable intake with mortality risk of all-cause and cardiovascular diseases (CVD) deaths.
METHODS:
This study included 24,034 adults aged 45 years or older with hypertension from the 2015 China Chronic Disease and Risk Factors Surveillance (CCDRFS). Death data were ascertained by linking each participant’s name and identification number to the China’s Disease Surveillance Points system through 31 December 2022. To better reflect long-term intake conditions, vegetable intake was assessed by a three-day 24-hour dietary recall, and fruit intake was derived from a food frequency questionnaire (FFQ). Weighted Cox proportional hazards regression models were used to estimate the associations between fruit and vegetable intake and mortality. Schoenfeld residuals were used to test the proportional hazards assumption, and no violation was observed. Restricted cubic spline (RCS) models were used to examine the dose-response relationships.
RESULTS:
Over a median 7.1-year follow-up, 2,503 all-cause deaths and 1,253 CVD deaths occurred. In the fully adjusted model, compared with the first quartile (<136.7g), the second (136.7-216.7g) and fourth (>318g) quarters of vegetable intake had lower risk of all-cause mortality (Q2: HR=0.81, [95% CI:0.66-0.99]; Q4: HR=0.80, [95%CI:0.66-0.97]), and CVD mortality (Q2: HR=0.71, [95% CI:0.54-0.93]; Q4: HR=0.72, [95% CI:0.55-0.95]). Compared with the first quartile (<10g), the second (10-42.9g) and fourth (>120g) quarters of fruit intake were associated with reductions in all-cause mortality (Q2: HR=0.82, [95% CI: 0.67-0.99]; Q4: HR=0.73, [95%CI: 0.59-0.90]). Nonlinear, L-shaped dose–response relationships were observed (all p for nonlinear <0.001), respectively.
CONCLUSIONS:
In this national study, higher fruit and vegetable intake is associated with decreased all-cause and CVD mortality, and depicted non-linear relationship among individuals with hypertension.
Previous studies have shown that fruit and vegetable intake was associated with a reduced risk of mortality. But evidence is limited among Chinese hypertension patients. This study explores the association of fruit and vegetable intake with mortality risk of all-cause and cardiovascular diseases (CVD) deaths.
METHODS:
This study included 24,034 adults aged 45 years or older with hypertension from the 2015 China Chronic Disease and Risk Factors Surveillance (CCDRFS). Death data were ascertained by linking each participant’s name and identification number to the China’s Disease Surveillance Points system through 31 December 2022. To better reflect long-term intake conditions, vegetable intake was assessed by a three-day 24-hour dietary recall, and fruit intake was derived from a food frequency questionnaire (FFQ). Weighted Cox proportional hazards regression models were used to estimate the associations between fruit and vegetable intake and mortality. Schoenfeld residuals were used to test the proportional hazards assumption, and no violation was observed. Restricted cubic spline (RCS) models were used to examine the dose-response relationships.
RESULTS:
Over a median 7.1-year follow-up, 2,503 all-cause deaths and 1,253 CVD deaths occurred. In the fully adjusted model, compared with the first quartile (<136.7g), the second (136.7-216.7g) and fourth (>318g) quarters of vegetable intake had lower risk of all-cause mortality (Q2: HR=0.81, [95% CI:0.66-0.99]; Q4: HR=0.80, [95%CI:0.66-0.97]), and CVD mortality (Q2: HR=0.71, [95% CI:0.54-0.93]; Q4: HR=0.72, [95% CI:0.55-0.95]). Compared with the first quartile (<10g), the second (10-42.9g) and fourth (>120g) quarters of fruit intake were associated with reductions in all-cause mortality (Q2: HR=0.82, [95% CI: 0.67-0.99]; Q4: HR=0.73, [95%CI: 0.59-0.90]). Nonlinear, L-shaped dose–response relationships were observed (all p for nonlinear <0.001), respectively.
CONCLUSIONS:
In this national study, higher fruit and vegetable intake is associated with decreased all-cause and CVD mortality, and depicted non-linear relationship among individuals with hypertension.
| eISSN: | 2654-1459 |
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