Regional Dietary Pattern Associated with the Risk of Hypertensive Dyslipidemia Multimorbidity in Chinese Elderly: Results from China Nutrition and Health Surveillance in 2015–2017

<b>Objectives:</b> This study investigated regional dietary patterns and their association with hypertensive dyslipidemia multimorbidity among older Chinese adults. <b>Methods:</b> Data from 13,809 individuals (aged ≥ 65 years) were extracted from the 2015-2017 China Nutrition and Health Surveillance. Hypertensive dyslipidemia multimorbidity was defined as concurrent hypertension and dyslipidemia. Four dietary patterns were identified via exploratory factor analysis using 3-day 24 h dietary records. <b>Results:</b> Four dietary patterns were extracted: traditional southern, diverse, high oil and salt, and animal oil-other animal meat-coarse grain pattern. The national prevalence of hypertensive dyslipidemia multimorbidity was 31.9%, with significant regional variation (highest in North China: 36.4%; lowest in Central China: 27.9%; <i>p</i> < 0.0001). Regional dietary dominance included: the traditional southern pattern in South China (75.9%); the traditional southern (35.8%) and diversified (28.8%) patterns in East China; animal oil-other animal meat-coarse grain (38.4%) and traditional southern (37.9%) patterns in Southwest China; high oil and salt (36.8%) and traditional southern (25.9%) in Central China; diversified (47.7%) and high oil and salt (26.3%) patterns in North China; high oil and salt (44.9%) and diversified (37.9%) patterns in Northwest China; and the diversified (46.9%) pattern in Northeast China. In the highest scoring group of the animal oil-other animal meat-coarse grain pattern, the risk of hypertensive dyslipidemia multimorbidity was 1.179 times greater compared with the lowest scoring group (Q4 vs. Q1, OR = 1.179, 95% CI: 1.032-1.316, <i>p</i> < 0.001). Region-specific analyses highlighted: increased risks with the traditional southern pattern in South/East China (Q4 vs. Q1, OR = 2.080, 95% CI: 1.036-4.175, <i>p</i> < 0.001) and (Q4 vs. Q1, OR = 1.734, 95% CI: 1.052-2.859, <i>p</i> < 0.001); protective effects of the diversified pattern in Northwest China (Q4 vs. Q1, OR = 0.377, 95% CI: 0.173-0.824, <i>p</i> < 0.001); elevated risks with the high oil and salt pattern in Central/North China (Q4 vs. Q1, OR = 2.343, 95% CI: 1.107-4.955, <i>p</i> < 0.001) and (Q4 vs. Q1, OR = 1.837, 95% CI: 1.019-3.312, <i>p</i> < 0.001); and higher risks with the animal oil-other animal meat-coarse grain pattern in Southwest China (Q4 vs. Q1, OR = 2.009, 95% CI: 1.004-4.021, <i>p</i> < 0.001). <b>Conclusions:</b> In conclusion, dietary patterns among elderly Chinese are diversified and should be optimized based on local food resources to control hypertensive dyslipidemia multimorbidity.