Impact of Mediterranean Diet Adherence on the Incidence of New‐Onset Hypertension in Adults With Obesity in Korea: A Nationwide Cohort Study

This study investigated the association between adherence to the Mediterranean diet (MD) and new-onset hypertension (HTN) in a cohort of community-dwelling, middle-aged, older Korean individuals with obesity. We used data from the Korean Genome and Epidemiology Study, a population-based prospective cohort study. The Korean version of the MD Adherence Screener was used to evaluate compliance with the MD. The primary endpoint was the incidence of new-onset HTN. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval for HTN incidence with increasing MD adherence. Data from 1995 participants with obesity without HTN at baseline were analyzed. After adjusting for confounders, participants with moderate (Group 2) and high adherence (Group 3) to the MD had HRs for new-onset HTN of 0.72 (0.57-0.90) and 0.73 (0.56-0.95), respectively, compared with those with low adherence (Group 1). Sex and age differences were associated with MD adherence and HTN incidence. The association between MD adherence and HTN incidence was only significant in males and in participants aged 40-64 years. There was no significant association between MD adherence and new-onset HTN in females or those aged ≥ 65 years. In conclusion, this study found a significant association between adherence to the MD and a reduction in new-onset HTN in Korean adults with obesity. Considering its value and sustainability, the adoption of the MD may contribute to the prevention of new-onset HTN in populations with obesity.