Association between tomato consumption and blood pressure in an older population at high cardiovascular risk: observational analysis of PREDIMED trial

Abstract

Abstract Aims Clinical studies have produced conflicting evidence on the effects of the consumption of tomatoes on blood pressure, and there are limited data from epidemiologic studies. This study assesses whether tomato consumption (Solanum lycopersicum L.) is associated with systolic and diastolic blood pressure, and the risk of hypertension in a prospective 3-year longitudinal study in older adults at high cardiovascular risk. Methods and results The present study was carried out within the PREDIMED (Prevención con Dieta Mediterránea) trial involving 7056 (82.5% hypertensive) participants. The consumption of tomato (g/day) was measured using a validated Food Frequency Questionnaire and categorized into four groups: lowest (<44 g), intermediate (44–82 g), upper-intermediate (82–110 g), and highest (>110 g). Multilevel linear mixed models examined blood pressure and tomato consumption association. Cox proportional-hazards models analysed hypertension risk in 1097 non-hypertensive participants, studying risk reductions vs. the lowest tomato consumers. An inverse association between tomato consumption and diastolic blood pressure was observed between the intermediate group β = −0.65 mmHg [95% confidence interval (CI): −1.20, −0.10] and the lowest consumption group. A significant inverse association was observed for blood pressure in grade 1 hypertension participants in the intermediate tomato consumption group. The risk of hypertension decreased with consumption of >110 g/day tomato (highest vs. lowest consumption; hazard ratio, 0.64 [95% CI, 0.51–0.89]). Conclusion Tomato consumption, including tomato-based products, is beneficial in preventing and managing hypertension. Higher tomato intake reduces hypertension risk by 36%, and moderate consumption lowers blood pressure, especially in grade 1 hypertension.