Ultraprocessed Food Consumption and Hypertension Risk in the REGARDS Cohort Study.

Background: This study examined the longitudinal association between ultraprocessed food (UPF) consumption and overall hypertension risk and explored the contribution of UPF to racial disparities in risk for hypertension.
Methods: We analyzed data from 5957 participants from the REGARDS cohort study (Reasons for Geographic and Racial Disparities in Stroke) free from hypertension during visit 1 (2003-2007), had complete dietary information at visit 1, and completed visit 2 (2013-2016). UPF consumption was measured using the Nova classification system and operationalized percent calories and grams. The main outcome was incident hypertension. Logistic regression was used for analysis.
Results: Thirty-six percent of participants developed hypertension at visit 2. Results showed a positive linear relationship between UPF and hypertension incidence. Aggregate model results showed that those in the highest UPF consumption quartile had 23% greater odds of incident hypertension compared with the lowest quartile. Multivariable results showed that Black and White participants in the highest consumption quartile had 1.26 (95% CI, 0.92-1.74) and 1.22 (95% CI, 1.01-1.47) greater odds of hypertension compared with those in the lowest quartile, respectively. Analyses using UPF consumption as percent grams showed similar aggregate results; however, race-stratified results differed. Findings were no longer statistically significant among White participants (odds ratio, 1.09 [95% CI, 0.89-1.33]) but showed significant differences in incident hypertension between Black participants in the highest versus lowest UPF quartiles (odds ratio, 1.43 [95% CI, 1.01-2.02]).
Conclusions: This study demonstrated that high consumption of UPF is associated with increased hypertension risk. Further research is warranted to better understand differences in the intakes of UPF subgroups that may underpin the racial differences in hypertension incidence observed with different UPF metrics.