Background: Due to rapid population growth and, subsequently, large-scale food production methods, ultra-processed food consumption is in parabolic growth. By affecting 1.28 billion adults globally, hypertension is a major risk factor and cause of premature death. In order to find the relation between ultra-processed food consumption and other covariates with hypertension incidence, this study was conducted in the western part of Iran using RaNCD prospective cohort data. Methods: We included 8150 participants at the risk of hypertension in the final analysis. Using the data obtained from the Iranian food frequency questionnaire and the NOVA food classification, we assessed the ultra-processed food consumption of each participant in a day. Logistic regression models and the Cox proportional hazards regression model were used to assess the association between ultra-processed food consumption and hypertension in the main model and sensitivity analysis. Results: The mean age of participants was 46.25y +- 7.94 (47.58% males); the mean follow-up time was 7.65y +- 1.62, and the mean daily UPF intake in g/d among participants was 88.07 +- 84.96. During the follow-up period, 862 cases of hypertension were recorded. We adjusted the main model for several confounders, including age, gender, residence type, marital status, socioeconomic status, physical activity, body mass index, familial history of hypertension, fasting blood sugar, and waist-to-hip ratio. The odds ratio and 95% confidence interval (95% CI) of the second and third tertile of UPFs were 1.15 (95% CI, 0.96-1.37) and 1.03 (95%CI, 0.85-1.24), respectively, compared to the first tertile with insignificant p-value & p-trend. Conclusion: To the best of our knowledge, our study is the first to assess the association between hypertension and ultra-processed foods in the Middle East region. Significant associations between hypertension incidence and some confounders were also identified.

The authors have declared no competing interest.

This study did not receive any funding

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Ethical approval for the study was obtained from the Kermanshah University of Medical Sciences Ethics Committee.

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All data produced in the present study are available upon reasonable request to the authors