Ultra‐Processed Food Consumption and Risk of Incident Hypertension in US Middle‐Aged Adults

Abstract

Background Consumption of ultra‐processed food, which is manufactured food that is high in additives and sparse in intact foods, is adversely associated with cardiovascular health, primarily in non‐US study populations. We aimed to estimate the association between ultra‐processed food consumption and incident hypertension in middle‐aged adults in the United States. Methods and Results We included 8923 ARIC (Atherosclerosis Risk in Communities) study participants who were hypertension free at baseline and had complete dietary, covariate, and hypertension data from visit 1 (1987–1989). Over a median (25th, 75th percentile) follow‐up of 13 (6–21) years, 79% of participants developed hypertension. Participants in the highest quartile of ultra‐processed food consumption had 15% higher risk of incident hypertension than those in the lowest quartile (hazard ratio [HR], 1.15 [95% CI, 1.08–1.23]). Participants in the highest quartile of consumption of sugar‐sweetened beverages, red and processed meat, and margarine had 16% (HR, 1.16 [95% CI, 1.08–1.24]; p‐trend <0.001), 10% (HR, 1.10 [95% CI, 1.03–1.19]; P trend = 0.005), and 6% (HR, 1.06 [95% CI, 0.99, 1.45]; P trend = 0.045) higher risk of incident hypertension, respectively, when compared with the lowest quartiles of consumption. Each additional serving of minimally or unprocessed food was associated with a 2% lower risk of incident hypertension (HR, 0.98 [95% CI, 0.98, 0.99], P <0.001). Conclusions High consumption of ultra‐processed foods, specifically of sugar‐sweetened beverages, red and processed meat, and margarine, was associated with a higher incidence of hypertension, whereas minimally or unprocessed food consumption was associated with lower hypertension risk.