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The Long-Term Benefits of the Mediterranean Diet in Preventing Hypertension

Dietary habits play a crucial role in our overall health, especially when it comes to conditions like hypertension (HTN). A recent 20-year prospective study, published in the European Journal of Clinical Nutrition in April 2024, sheds light on the profound impact of the Mediterranean diet on reducing the risk of developing HTN over time.

Understanding the Study

The study, conducted by Michael Georgoulis and colleagues, followed 1415 non-hypertensive adults over two decades to assess the relationship between adherence to the Mediterranean diet and the incidence of hypertension. Participants, who were initially free of hypertension, had their dietary habits evaluated using the MedDietScore—a comprehensive tool that measures adherence to the Mediterranean diet based on a range of dietary components.

Mediterranean diet

Key Findings

Over the 20-year period, 314 new cases of hypertension were identified among the participants. The study found a significant inverse relationship between adherence to the Mediterranean diet and the incidence of hypertension. Participants with higher baseline MedDietScore, indicating greater adherence to the Mediterranean diet, had substantially lower rates of hypertension. Specifically, those in the highest tertile of MedDietScore at baseline had an 8.7% incidence of hypertension compared to 35.5% in the lowest tertile. A tertile is a statistical term used to divide a set of data into three equal parts.

Importantly, sustained adherence to the Mediterranean diet over time showed even more profound benefits. Participants who maintained a high MedDietScore both at baseline and at the 10-year follow-up had a remarkable 47% lower risk of developing hypertension compared to those who consistently scored low on the diet scale.

Clinical Insights

The findings underscore the protective effects of the Mediterranean diet against hypertension, even after adjusting for various lifestyle factors and clinical parameters such as body mass index, physical activity, smoking, blood pressure levels, and medical history. Each 1-point increase in MedDietScore at baseline was associated with a 7% reduction in the relative risk of hypertension over the 20-year period, highlighting the cumulative benefits of dietary habits on long-term health outcomes.

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Relevance to Type 2 Diabetes Mellitus (T2DM)

Beyond hypertension, the Mediterranean diet has been extensively studied for its impact on other chronic conditions, including T2DM. Similar to hypertension, T2DM shares common risk factors such as obesity, insulin resistance, and inflammation, which dietary patterns can influence.

Research suggests that adherence to the Mediterranean diet is associated with improved insulin sensitivity, better glycemic control, and reduced risk of developing T2DM. The emphasis on whole grains, fruits, vegetables, legumes, nuts, and healthy fats aligns with dietary recommendations beneficial for managing blood sugar levels and preventing the onset of T2DM.

What Does This Mean for Patients with Hypertension?

For individuals concerned about hypertension or those looking to prevent its onset, adopting and maintaining a Mediterranean-style diet could be highly beneficial. The diet, rich in fruits, vegetables, whole grains, fish, nuts, and olive oil, not only supports cardiovascular health but also helps in managing blood pressure levels over time. By emphasizing wholesome, nutrient-dense foods and minimizing processed foods and saturated fats, individuals can potentially reduce their risk of hypertension and its associated complications.

Mediterranean diet

What Does This Mean for Patients with Hypertension and T2DM?

For individuals managing both hypertension and T2DM or those at risk for these conditions, adopting a Mediterranean-style diet can offer dual benefits. By promoting cardiovascular health through blood pressure management and supporting glycemic control, this dietary approach provides a holistic strategy for reducing the overall risk of cardiovascular complications.

Key Principles of the Mediterranean Diet

The Mediterranean diet is celebrated worldwide for its health-promoting benefits and holistic approach to eating. Central to this dietary pattern is a high consumption of plant-based foods. Fruits, vegetables, whole grains, nuts, seeds, and legumes form the foundation of meals, providing essential vitamins, minerals, fiber, and antioxidants crucial for overall health.

Healthy fats are another cornerstone of the Mediterranean diet. Olive oil is the primary source of added fat, rich in monounsaturated fats and associated with numerous health benefits, including heart health. Additionally, nuts, seeds, and fatty fish, such as salmon and sardines, contribute to the diet's healthy fat profile, offering omega-3 fatty acids essential for brain and heart health.

Moderate consumption of dairy products, particularly yogurt and cheese, is typical in Mediterranean cuisine. Poultry and eggs are also included but in smaller quantities compared to plant-based foods. Fish and seafood, consumed several times a week, provide lean protein and omega-3s, contributing to the diet's protective effects against chronic diseases.

Red meat is limited in the Mediterranean diet, with consumption typically reserved for occasional indulgences rather than daily meals. Instead of using excessive salt, Mediterranean dishes are seasoned with herbs, spices, and garlic, not only enhancing flavor but also providing additional health benefits.

In addition to its dietary components, the Mediterranean lifestyle emphasizes regular physical activity and social interactions, both of which contribute significantly to overall well-being. This comprehensive approach to health underscores the Mediterranean diet's reputation as a sustainable and enjoyable dietary pattern with numerous health benefits, including reducing the risk of chronic diseases like cardiovascular disease, diabetes, and certain cancers.


The ATTICA prospective epidemiological study provides compelling evidence that adherence to the Mediterranean diet is associated with a lower incidence of hypertension over a 20-year period. Whether you're aiming to prevent hypertension, T2DM, or manage your overall cardiovascular health, incorporating Mediterranean dietary principles into your daily routine may offer substantial long-term benefits.

As we continue to explore the intricate relationship between diet and chronic diseases, studies like this reinforce the pivotal role of dietary patterns in promoting health and preventing disease. By making informed choices about what we eat, we empower ourselves to lead healthier, more vibrant lives.



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