European Journal of Nutrition

, Volume 58, Issue 1, pp 455–466 | Cite as

A priori dietary patterns and blood pressure in the EPIC Florence cohort: a cross-sectional study

  • B. Bendinelli
  • G. MasalaEmail author
  • R. M. Bruno
  • S. Caini
  • C. Saieva
  • A. Boninsegni
  • A. Ungar
  • L. Ghiadoni
  • D. Palli
Original Contribution



Several foods and nutrients have been independently associated with systolic (SBP) and diastolic (DBP) blood pressure values. This study aimed to evaluate the effects of combined dietary habits on SBP and DBP values in a large cohort of healthy adults, with a cross-sectional design. Adherence of participants to four a priori dietary patterns was considered: the Healthy Eating Index 2010 (HEI-2010); the Dietary Approaches to Stop Hypertension (DASH); the Greek Mediterranean Diet Score (MDS); and the Italian Mediterranean Index (IMI).


Overall, 13,597 volunteers (35–64 years) were enrolled in 1993–1998 in the EPIC-Florence cohort. Information on dietary habits, anthropometry, smoking status, education, physical activity habits, previous diagnosis of hypertension and SBP and DBP measurements were collected at baseline. Multivariate regression models were performed on 10,163 individuals (7551 women) after excluding subjects with prevalent hypertension.


IMI, DASH and HEI-2010 were significantly and inversely associated with SBP and DBP values in the total population. The strongest association emerged between IMI and SBP (β − 1.80 excellent adherence vs low adherence, 95% CI − 2.99; − 0.61, p trend 0.001) and DBP (β − 1.12, 95% CI − 1.869; − 0.39, p trend 0.001) values. In sub-group analyses, an inverse association also emerged between IMI and SBP and DBP values among females and between DASH and DBP among males. MDS was not associated with SBP or DBP.


Overall, this study, carried out in a large cohort of healthy adults from Tuscany (Central Italy), showed inverse significant associations between specific a priori dietary patterns, identifying general models of health-conscious diet, and blood pressure values.


A priori dietary pattern Blood pressure Cross-sectional design Cohort study 



The authors wish to acknowledge the cooperation of all study participants and staff members. The EPIC study was supported by the Associazione Italiana per la Ricerca sul Cancro (AIRC), Milan, Italy.

Compliance with ethical standards

Ethical standards

The EPIC study has been approved by the Ethical Review Board of the International Agency for Research on Cancer (IARC, Lyon) and by the local Florence Ethical Committee and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

At enrolment, all participants in the EPIC study signed an informed consent form and agreed to provide detailed information on their dietary and lifestyle habits and their health status.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

394_2018_1758_MOESM1_ESM.doc (404 kb)
Supplementary material 1 (DOC 403 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cancer Risk Factors and Lifestyle Epidemiology UnitInstitute for cancer research, prevention and clinical network, ISPROFlorenceItaly
  2. 2.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  3. 3.Division of Geriatric Cardiology and MedicineUniversity of FlorenceFlorenceItaly
  4. 4.Azienda Ospedaliero-Universitaria CareggiFlorenceItaly

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