Consumption of fruits, vegetables, and nuts influences the association between serum uric acid and hypertension in Korean adults: A nationwide survey (KNHANES 2016-2021).

Background and objectives: This study investigated the influence of dietary intake on the relationship between serum uric acid (SUA) levels and the risk of hypertension.

Methods and study design: Data from the 7th and 8th Korean National Health and Nutrition Examination Survey, a nationally representative survey, were analyzed. A total of 19,140 adults aged 19-64 years were included. Dietary intake was assessed using a 24-hour recall method. SUA levels were measured using a Hitachi Automatic Analyzer 7600-210. Hyperten-sion was defined as a systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medication. Statistical analyses included generalized linear regression, Cochran-Mantel-Haenszel analysis, and multivariate logistic regression.

Results: The highest SUA quartile (Q4) had an odds ratio (OR) of 1.68 (95% CI: 1.41-1.99) for hypertension compared to the lowest quartile (Q1). Additionally, the association between elevated SUA levels and increased hypertension risk was stronger in participants who consumed fewer fruits (OR: 1.79, 95% CI: 1.44-2.21), vegetables (1.80, 1.43-2.25), nuts (1.87, 1.51-2.33), and milk (2.20, 1.73-2.79). The ORs (95 % CI) for the highest SUA quartile on hypertension were 1.68 (1.39-2.04), 1.35 (1.13-1.62), and 1.89 (1.57-2.27) in those consuming more seafood, meat, and alcohol, respectively.

Conclusions: Reduced intake of fruits, vegetables, nuts, and milk, and increased consumption of seafood and alcohol, exacerbates the positive association between SUA levels and the risk of hypertension. These findings suggest dietary modifications as a potential strategy for hypertension prevention and management.