The higher dietary energy-to-fiber ratio is associated with an increased risk of poor blood pressure control among patients with essential hypertension: a cross-sectional study

Introduction Dietary fiber (DF) and energy intake are two noted factors in the dietary management of hypertensive patients, which are associated with blood pressure (BP) control. We hypothesized that a higher energy-to-fiber ratio (EFR) is a stronger associated factor for BP control in the hypertensive population. Methods Subjects from one comprehensive hospital and one community clinic in China were included in this cross-sectional study ( n = 454). Dietary intake was measured by 2 non-consecutive 24 h dietary recalls. The EFR was calculated from the ratio of dietary energy (kcal/d) to DF (g/d). Results According to the quartile grouping of EFR from low to high, the participants were divided into Q1, Q2, Q3, and Q4 groups, respectively. Poor BP control was defined as systolic BP (SBP) ≥ 140 mmHg and diastolic BP (DBP) ≥ 90 mmHg. In binary logistic regression, taking Q1 as the reference, higher EFRs in Q3 (OR, 2.112; 95% CI, 1.110–4.019) and Q4 (OR, 7.233; 95% CI, 3.709–14.105) were associated with higher rates of poorly controlled SBP and higher EFRs in Q4 (OR, 3.546; 95% CI, 1.836–6.848) were associated with higher rates of poorly controlled DBP, after adjusting for covariates. The correlations between EFR and BP control were stronger than DF or energy alone. A high EFR was a stronger associated factor for poor BP control among patients with essential hypertension. Conclusions Given the strong association between diet and hypertension, the indicator EFR should be considered when assessing hypertensive patients’ nutritional status and formulating nutritional strategies.