Low vegetable consumption doubles the odds of stroke among people with hypertension: Findings from the SIREN Study in West Africa

Authors

• Osahon Jeffery Asowata, University of Ibadan
• Ifeoluwa Bodunde, Lead City University
• Akinkunmi Paul Okekunle, Seoul National University
• Onoja Matthew Akpa, University of Ibadan
• David Kadan Danladi, University of Ibadan
• Adekunle Gregory Fakunle, Osun State University
• Morenikeji A. Komolafe, Obafemi Awolowo University
• Reginald Obiako, Ahmadu Bello University
• Kolawole Wahab, University of Ilorin
• Joshua Akinyemi, University of Ibadan
• Albert Akpalu, University of Ghana
• Olayinka Adebajo, College of Medicine, University of Ibadan
• Kelechukwu Uwanuruochi, Federal Medical Centre Nigeria
• Samuel Olowookere, Obafemi Awolowo University
• Oyedunni Arulogun, University of Ibadan
• Arti Singh, Kwame Nkrumah University of Science & Technology
• Paul Olowoyo, Federal Teaching Hospital
• Oladotun Olalusi, College of Medicine, University of Ibadan
• Godwin Inalegwu Ogbole, College of Medicine, University of Ibadan
• Ganiyu Adeniyi Amusa, University of Jos
• Sunday Adeniyi, University of Ilorin
• Innocent Ijezie Chukwuonye, Federal Medical Centre Nigeria
• Okechukwu Ogah, College of Medicine, University of Ibadan
• Suleiman Y. Isah, Bayero University
• Philip O. Ibinaiye, Ahmadu Bello University
• Ayodipupo Oguntade, College of Medicine, University of Ibadan
• Eunice Olabinri, Federal Medical Centre Nigeria
• Adebolajo Adeyemo, Federal Medical Centre Nigeria

Abstract

Background: While hypertension is a primary risk factor for higher stroke risk, adequate vegetable consumption has been linked with a lower odds of stroke. However, it is unclear whether low/inadequate vegetable consumption could aggravate the odds of stroke among people with hypertension. This study assessed the interaction of low vegetable consumption and hypertension with stroke among West Africans. Methods: In this case–control study, 3684 stroke cases (aged ⩾ 18 years) matched for age ±5 years, sex, and ethnicity, with 3684 healthy controls were recruited across multiple sites in Nigeria and Ghana. Hypertension was defined using standard guidelines, and vegetable consumption was assessed with a food frequency questionnaire. Multivariable-adjusted conditional logistic regression and interaction models were used to estimate the odds ratios (OR) with a 95% confidence interval (CI) of stroke and the synergistic interaction of both low vegetable consumption (< 6 servings per week) and hypertension. The attributable proportion (AP), relative excess risk due to interaction (RERI), and synergy index (SI) were estimated at a two-sided P < 0.05. Results: Overall, the mean age was 59.0 ± 14.9 years, and 45.8% (3376) were female. Among stroke cases, the prevalence of low vegetable consumption and hypertension was 68.1% (2508) and 95.9% (3480), respectively. The multivariable-adjusted odds of stroke, given low vegetable consumption with hypertension, were OR = 25.66 (95% CI = 16.65, 39.54) with an RERI of 13.40 (95% CI = 7.21, 19.59), AP of 0.52 (95% CI = 0.44, 0.60), SI of 2.19 (95% CI = 1.82, 2.63), and a multiplicative interaction of about 50%; 1.51 (95% CI = 0.91, 2.49). Conclusion: The odds of stroke double with low vegetable consumption among people with hypertension in this population.

Publication Title

International Journal of Stroke

Recommended Citation

Asowata, O., Bodunde, I., Okekunle, A., Akpa, O., Danladi, D., Fakunle, A., Komolafe, M., Obiako, R., Wahab, K., Akinyemi, J., Akpalu, A., Adebajo, O., Uwanuruochi, K., Olowookere, S., Arulogun, O., Singh, A., Olowoyo, P., Olalusi, O., Ogbole, G., Amusa, G., Adeniyi, S., Chukwuonye, I., Ogah, O., Isah, S., Ibinaiye, P., Oguntade, A., Olabinri, E., & Adeyemo, A. (2025). Low vegetable consumption doubles the odds of stroke among people with hypertension: Findings from the SIREN Study in West Africa. International Journal of Stroke, 20 (9), 1159-1169. https://doi.org/10.1177/17474930251349474