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Distinctive unhealthy eating pattern in free-living middle-aged hypertensives when compared with dyslipidemic or overweight patients

Objective: To evaluate habitual dietary intakes in patients with established hypertension, dyslipidemia and/or overweight. Methods: A national sample of 6167 French free-living patients, aged 45–65 years, in whom daily food and nutrient intakes (24-h records) and clinical status were regularly monitored between 1994 and 2002. Results: For each disorder, affected patients have reduced fat and energy intakes compared with nonaffected participants after adjustment for confounding factors. In addition, after further adjustment for energy intake, dyslipidemic patients eat less cheeses, sweets, eggs and appetizers, whereas overweight patients eat less bread and sweets, more yoghurts, vegetables, meats and poultries in comparison to their nonaffected counterparts. By contrast, hypertensive patients drink more wines and less milk, eat less yoghurts, fruits and vegetables, more processed meats than participants without hypertension. Nutrient intakes also reflect these distinctive eating patterns as shown by reduced carbohydrate intake and increased protein and mineral intakes in overweight patients and increased alcohol intake and decreased mineral intakes in hypertensives when compared with nonaffected participants. Among affected patients, antihypertensive and hypolipidemic drug treatments are not associated with additional differences in daily food and nutrient intakes except eggs that are consumed in smaller amounts by treated dyslipidemic patients. Conclusion: Hypertensive patients maintain an unhealthy eating pattern that tends to perpetuate their disorder in contrast to dyslipidemic or overweight patients who adopt more protective diets. The origin of this behavioural difference and poor adherence to practice guidelines between hypertensives and other cardiovascular risk patients needs to be investigated.