Low vegetable consumption combined with hypertension significantly doubles the risk of stroke, particularly when hypertension is untreated, underscoring the need for integrated, multidimensional stroke prevention strategies in West Africa, a study has reported.
In this new study, researchers highlighted the critical role of dietary habits in managing stroke risk, noting that increasing vegetable intake could significantly contribute to stroke prevention, especially among hypertensive populations.
The Stroke Investigation Research and Educational Network (SIREN), a multi-centre case-control study conducted at 15 hospital sites across Nigeria and Ghana, provided the data for the study. Published in the June issue of the International Journal of Stroke, it featured contributions from Osahon Asowata, Akinkunmi Okekunle, Mayowa Owolabi, and others.
The SIREN study recruited 3,684 stroke case-control pairs, with a mean age of 59 years. Notably, 76.6 percent of participants were hypertensive, and 62.8 percent consumed fewer than six portions of vegetables per week—considered low intake.
Researchers assessed the interaction between low vegetable consumption and hypertension with stroke, categorizing hypertension treatment as untreated, treated and controlled, or treated but uncontrolled.
Dietary consumption was measured by the frequency of servings alone, without accounting for portion size, food preparation variations, or the nutrient composition of the diet.
The study found that low vegetable consumption, in the presence of hypertension, increases the odds of stroke by more than tenfold through an additive, synergistic interaction.
“Our findings align with other studies that highlight the critical role of inadequate vegetable consumption and hypertension in the development of stroke and cardiovascular disease (CVD). Hypertension remains the primary risk factor for stroke, with a disproportionately high burden among Africans, and pharmacological intervention is still undoubtedly essential.
“Moreover, adopting dietary and lifestyle interventions could be promising within robust care and personalized medicine approaches for stroke prevention, given the well-documented importance of vegetable consumption in mitigating CVD risk, even among hypertensive individuals.
“By illustrating how low vegetable intake and hypertension jointly increase stroke risk, our findings emphasize the need for integrated and complementary intervention strategies.”
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Earlier research had reported that hypertensive individuals with low vegetable intake had an odds ratio of 31.7 for stroke compared to those without these risk factors—indicating a significant interaction between low vegetable consumption and hypertension in stroke incidence.
The World Health Organization recommends consuming at least 400 grams (five servings) of fruits and vegetables daily for optimal health.
Vegetables are rich in potassium and magnesium, which help lower blood pressure—a major stroke risk factor. Many vegetables also contain antioxidants and phytochemicals that reduce inflammation and oxidative stress, both linked to increased stroke risk.
In addition, high fibre intake from vegetables is associated with improved cholesterol levels and better insulin sensitivity, further lowering the risk of stroke.
Adherence to diets like the Mediterranean or DASH, which emphasize vegetable consumption, has been shown to reduce stroke incidence.
Stroke remains a significant public health concern, being the second leading cause of death and disability-adjusted life years globally, with Africa bearing a disproportionate share of the global stroke burden.
Multiple risk factors contribute to the rising incidence of stroke, and studies have established that both hypertension and vegetable consumption are modifiable factors strongly linked to stroke risk.