Am J Med. 2026 Jul 25:S0002-9343(26)00534-6. doi: 10.1016/j.amjmed.2026.07.006. Online ahead of print.
ABSTRACT
BACKGROUND: Lower socioeconomic status associates with greater risk for cardiovascular disease and chronic kidney disease progression but socioeconomic status factors that mediate these risks remain unclear. We tested the hypothesis that higher urine albumin excretion is associated with lower fruit and vegetable intake and lower household income, the latter a surrogate for lower socioeconomic status.
METHODS: We cross-sectionally matched 153 non-diabetic participants with primary hypertension, normal estimated glomerular filtration rate (≥ 90 ml/min/1.73 m2) and high (HIGH, >200 µg/min) with 153 with low (LOW, <20 µg/min) urine albumin excretion. We used multivariable linear regression with least square means to examine associations between urine albumin excretion and fruit and vegetable intake.
RESULTS: Least squares means for fruit and vegetable intake was lower (1.66 cups/day [1.57 - 1.74] vs. 2.24 cups/day [2.15 - 2.33]) in HIGH than LOW. After adjustments, higher urine albumin excretion was associated with lower fruit and vegetable intake (β = 2.23, SE = 0.044, p < 0.0001). Furthermore, fruit and vegetable intake had a strong positive association (coefficient = 0.85, p < 0.0001), and urine albumin excretion had a weak negative association (β= -0.25, SE = 0.02, p < 0.0001) with household income.
CONCLUSIONS: These cross-sectional data show an association between low socioeconomic status-mediated low fruit and vegetable intake and high urine albumin excretion in participants with non-diabetic primary hypertension. The data support follow-up studies to establish a causal link between these phenomena and whether this relationship applies to other diseases like diabetes.
PMID:42501955 | DOI:10.1016/j.amjmed.2026.07.006