LAUSR

Introduction: Little is known about whether prevailing diet quality scores apply to Hispanics/Latinos when assessing hypertension risk or if a diet score applied to a traditional diet would be more relevant. Objective: To compare a traditional Mexican diet score (tMexS) against three prevailing diet quality scores (Mediterranean Diet Score [MeDS], Alternate Healthy Eating Index-2010 [AHEI-2010], and Dietary Approaches to Stop Hypertension [DASH]) in association with risk of hypertension and change in systolic and diastolic blood pressure (BP) in adults of Mexican heritage in the U.S. Methods: Data were analyzed from 3,542 U.S. adults of Mexican heritage in the multicenter population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort with baseline (2008-2011) and follow-up (2014-2017) visits, and without CVD and hypertension at baseline. Diet quality scores were calculated from the average of two 24-h recalls. Higher scores of MeDS, AHEI-2010, and DASH indicate a healthier diet, while a higher tMexS indicates a more traditional Mexican diet. Hypertension was defined as an average of ≥140 systolic or ≥90 mmHg diastolic BP from triplicate measurements, or self-reported use of antihypertensive medications. Logistic regression models tested the association of four dietary scores with incident hypertension, and linear regression models tested the association of dietary scores and changes in systolic and diastolic BP by hypertension status. Multivariable models with complex survey procedures were adjusted for confounders, and the final model included all dietary scores simultaneously. Results: After an average 6y of follow-up, there were 553 incident cases of hypertension. Mean (±SE) total score was 5.8 ± 0.05 for tMexS (range: 0-12), 5.3 ± 0.04 for MeDS (range: 0-9), 51.4 ± 0.19 for AHEI-2010 (range: 0-110), and 48.5 ± 0.22 for DASH (range: 0-90). The tMexS, MeDS, and DASH were not associated with risk of hypertension. A 10-unit increase in the AHEI-2010 was associated with a lower risk of hypertension (OR: 0.77; 95% CI: 0.60, 0.98). Among normotensive adults, diastolic BP decreased by 0.24 ± 0.11 mmHg per one-unit increase in tMexS (p-value=0.02). No significant changes were noted for systolic BP nor among adults with hypertension. Conclusions: In this prospective cohort, the AHEI-2010, but not DASH, MeDS, or tMexS, was associated with lower hypertension risk among U.S. adults of Mexican heritage, while the tMexS reduced diastolic BP among normotensive adults. To decrease hypertension risk, adults of Mexican heritage should adhere to AHEI-2010 dietary recommendations, while consuming traditional Mexican foods for modest benefits on blood pressure.