Association of Dietary Patterns with All-Cause and Cause-Specific Mortality in a High Cardiovascular Risk Population in China

Purpose This study investigated dietary patterns among populations at high risk for cardiovascular disease (CVD) in Hunan Province and examined their associations with mortality. Methods Data were obtained from the China Health Evaluation and Risk Reduction through Nationwide Teamwork (ChinaHEART) project conducted between 2014 and 2023. A total of 46,239 individuals aged 35–75 years who were identified as being at high risk for CVD were included in the analysis. Major dietary patterns were derived using exploratory factor analysis. Baseline characteristics, survival analyses, and Cox proportional hazards regression models were performed using SPSS version 25.0 and R version 4.4.3 to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results Compared with the "Rice Pattern" greater adherence to the "Meat, Eggs, and Fresh Vegetables Pattern" was associated with significantly lower risks of all-cause mortality (HR = 0.64, 95% CI: 0.50–0.82; P  < 0.001) and chronic cardiovascular disease mortality (HR = 0.44, 95% CI: 0.24–0.77; P  < 0.01). These associations were consistently observed across population subgroups in stratified analyses and remained robust in sensitivity analyses. Conclusion These findings provide evidence-based support for dietary guidance in high-risk populations and have important implications for the prevention and management of cardiovascular disease.