# Fruit and Vegetable Consumption and Its Public Health Implications for Hypertension Among Peruvian Aged 15 Years and Older: Evidence from the 2022–2023 Demographic and Health Survey

## TL;DR

This study found no significant link between fruit and vegetable consumption and hypertension in Peru, but age and obesity were major risk factors.

## Contribution

The study provides post-pandemic evidence on hypertension risk factors in a low- to middle-income country.

## Key findings

- 14.20% of Peruvian adults had hypertension.
- Fruit and vegetable consumption was not significantly associated with hypertension or pre-hypertension.
- Older age and obesity were strongly linked to hypertension, especially diastolic hypertension.

## Abstract

Background: Hypertension (HTN) remains a major non-communicable disease globally and a leading cause of cardiovascular morbidity. Fruit and vegetable consumption (FVC) has been widely promoted as a preventive strategy, yet post-pandemic evidence from low- and middle-income countries remains limited. Objective: This study aimed to examine the association between the consumption of five or more servings of fruits and vegetables and hypertension among the Peruvian population during the post-COVID-19 period. Methods: A cross-sectional analytical study was conducted using data from the 2022–2023 Peru Demographic and Health Survey (DHS). The final weighted sample included 64,347 individuals aged 15 years and older. Multinomial logistic regression and robust Poisson regression models were applied, accounting for complex survey design and sampling weights, to estimate relative risk ratios (RRR), prevalence ratios (PR) and 95% confidence intervals (CIs) for pre-hypertension, hypertension and its subtypes. Results: Overall, 14.20% of the Peruvian adult population presented with hypertension. Consumption of fruits and vegetables was not significantly associated with either pre-hypertension or hypertension (p > 0.05). In contrast, older age (aRRR = 47.55; p < 0.001) and obesity (aRRR = 7.16; p < 0.001) were strongly associated with hypertension. When classifying hypertension by subtype (systolic or diastolic), fruit and vegetable intake remained non-significant (p > 0.05), while obesity exerted a stronger effect on diastolic hypertension (aPR = 9.04; p < 0.001). Conclusions: No significant association was found between fruit and vegetable consumption and hypertension among Peruvians during the post-COVID-19 period. However, age and body mass index were key determinants of both pre-hypertension and HTN, highlighting the need for broader, integrated public health strategies beyond dietary promotion alone.