Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study

Abstract

Objective: In low-income countries, such as Ethiopia, few studies have evaluated the risk of cardiovascular disease (CVD) among hypertensive patients. We assessed the 10-year CVD risk of hypertensive patients.

Design: This cross-sectional study was part of a larger survey conducted in Addis Ababa. The 10-year CVD risk was calculated using the Framingham Risk Score (FRS) algorithm based on seven sex-specific risk factors as well as a country-specific Globorisk score. Fruits and vegetables (FV) consumption, salt intake and stress levels were measured with 24-hour dietary recall, INTERSALT equation and Cohen's Perceived Stress Scale, respectively. A multiple linear regression model was fitted to explore the association.

Setting: Addis Ababa, Ethiopia, 2021.

Participants: A sample of 191 patients diagnosed with hypertension.

Outcome measures: Predicted 10-year cardiovascular risk of hypertensive patients.

Results: A total of 42.4%, 27.7% and 29.8% of hypertensive patients were at low, moderate and high CVD risks, respectively. The majority (80.1%) of patients consumed inadequate FV, 95.7% consumed salt >5 g/day and 58.1% had moderate to high-stress levels. There was a substantial agreement between the FRS and Globorisk prediction models (weighted kappa 0.77). In the unadjusted model, FV consumption (>450 g/day) and total fruit intake in the highest tertile were associated with 14.2% and 6.7% lower CVD risk, respectively. After adjusting for lifestyle factors, increasing FV intake from 120 to 450 g/day was significantly related to 11.1%-15.2% lower CVD risk in a dose-response manner. Additionally, total fruit, but not total vegetable intake in the highest tertile, was significantly associated with decreased CVD risk.

Conclusion: We found a high prevalence of CVD risk among hypertensive patients. High FV consumption was inversely associated with CVD risk. This suggests that patients should be advised to increase FV intake to minimise CVD risk.

Keywords: EPIDEMIOLOGY; Hypertension; NUTRITION & DIETETICS.