Ultra-processed foods, changes in blood pressure, and incidence of hypertension: results of Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Objective To estimate changes in blood pressure and the incidence of hypertension associated with consumption of ultra-processed foods (UPF) by Brazilian civil servants at a four-year follow-up. Design Longitudinal analysis of the ELSA-Brasil with non-hypertensive individuals at baseline. We applied the food frequency questionnaire at the baseline and categorized energy intake by degree of processing, using the NOVA classification. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at baseline (2008-2010) and again at first follow-up (2012-2014). Incidence of arterial hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or antihypertensive medication during the previous two weeks. A mixed-effect linear regression model and mixed-effect logistic regression model were used to estimate associations between UPF consumption and, respectively, changes in blood pressure and incidence of hypertension. Setting Brazil. Subjects Civil servants of Brazilian public academic institutions in six cities (n 8,754), aged 35-74 years at baseline (2008-2010). Results UPF consumption contributed 25.2% (SD = 9.6) of total calories consumed. After adjustment, participants with high UPF consumption presented a 23% greater risk of developing hypertension (OR = 1.23, 95% CI: 1.06-1.44) than those with low UPF consumption. We did not find association between UPF consumption and changes in blood pressure over time. Conclusions The higher the UPF consumption, the higher was the risk of hypertension in adults. Reducing UPF consumption is thus important to promote health and prevent hypertension.