Dietary Determinants of Hypertension: Trends in Ultra-Processed Food Consumption and Blood Pressure Control in U.S. Adults, 2013–2023

Abstract

Hypertension is one of the major global contributors to cardiovascular illness and death, with its occurrence closely linked to eating behaviors. Although medical treatments have improved, effective control of high blood pressure at the population level remains limited, emphasizing the need to identify dietary factors that can be changed. This research utilized data from the U.S. National Health and Nutrition Examination Survey (NHANES), a nationally representative dataset, to analyze dietary habits, hypertension awareness, management, and control. The main dietary variables assessed included the consumption of ultra-processed products, processed meats, sugarsweetened drinks, preserved foods, fruits, vegetables, and potassium levels. Hypertension status was determined through standardized blood pressure assessments or participants’ self-reported medical diagnoses. Findings indicated that ultra-processed foods made up more than 60% of total energy intake among adolescents and over 50% among adults from 2013–2014 to 2021–2023, showing little sign of reduction. Awareness and treatment of hypertension remained relatively unchanged between 2017–2020 and 2021–2023, while the control rate declined from 22.2% to 20.7%. These results highlight key dietary elements contributing to hypertension risk in the general population and reinforce the urgency of implementing public health strategies that support healthier food choices and environments.