Abstract / Summary
This study aimed to examine long-term trends in fruit and vegetable (FV) consumption among treated and untreated adults with hypertension in Iran. We analyzed nationally representative WHO STEPS data from Iran (2007, 2011, 2016, and 2021) among adults aged 18–64 years with hypertension, defined by measured blood pressure, prior diagnosis, or use of antihypertensive medication. Age-standardized FV intake was estimated and reported with 95% confidence intervals (95%CIs), and temporal trends were assessed using survey-weighted regression models. Among adults with hypertension, age-standardized FV showed variable changes over the study period, with an overall decrease from 4.48 days per week (4.39–4.58) in 2007 to 4.11 days per week (4.02–4.19) in 2021. FV intake was consistently higher among females and urban residents compared with others. Treated individuals reported more frequent FV consumption than untreated individuals, particularly in the later survey cycles. The prevalence of FV consumption ≥ 5 days/week also showed an overall declining trend, decreasing from 45.62% (95% CI: 43.03–48.21) in 2007 to 38.58% (95% CI: 36.46–40.70) in 2021, with annual rate change of − 1.44% (95% CI: −1.99 to − 0.92) overall, − 1.70% (− 2.26 to − 1.15) among untreated, and + 1.41% (− 0.22 to 3.13) among treated hypertensive adults. FV intake among Iranian hypertensive adults showed fluctuating patterns over 15 years, with overall lower consumption in recent survey cycles. The observed differences between females and males, as well as between treated and untreated participants, highlight the importance of targeted dietary interventions in high-risk populations.