Researchers measured adherence to a Mediterranean lifestyle with a composite score ranging from 0 to 24. The score combined six domains: Mediterranean diet adherence, physical activity, water intake, sleep, social isolation and cooking activities. The investigators assessed the relationship between the lifestyle score and three cardiovascular outcomes: hypertension, myocardial infarction and stroke.

They used logistic regression models for both cross-sectional and longitudinal analyses, adjusting the models for age and sex. The cross-sectional models examined associations with existing hypertension, while the longitudinal models assessed associations with cardiovascular events occurring during follow-up. Higher adherence to the overall Mediterranean lifestyle score was significantly associated with lower odds of prevalent hypertension after adjustment for age and sex.

Because the finding was cross-sectional, it describes an association among participants who already had hypertension rather than demonstrating that the lifestyle pattern prevented, reversed or improved the condition. For the longitudinal analysis, however, the composite lifestyle score was not significantly associated with incident hypertension, myocardial infarction or stroke. This means the study did not find evidence of a statistically significant prospective relationship between the broad lifestyle score and those outcomes in the model presented.

It does not establish that no such relationship exists, because a nonsignificant result is not equivalent to proof of no association. The component-level analysis produced a more specific result: higher Mediterranean diet adherence was prospectively associated with lower odds of incident myocardial infarction. The study’s summary describes this as supporting the potential relevance of Mediterranean dietary habits for cardiovascular health in older age.

By contrast, the other individual lifestyle components examined—physical activity, water intake, sleep, social isolation and cooking activities—did not show significant adjusted associations with the cardiovascular outcomes analyzed. The distinction between the two forms of analysis is central to the results. The cross-sectional hypertension finding concerns the prevalence of an existing condition, whereas the myocardial infarction finding concerns the occurrence of a new event during follow-up.

The analysis of individual components also should not be conflated with the overall lifestyle score: the prospective association was reported for Mediterranean diet adherence, not for the full six-domain Mediterranean lifestyle pattern. As an observational study, the research can identify associations but cannot establish that following a Mediterranean lifestyle or a specific component caused better cardiovascular outcomes. The use of logistic regression and adjustment for age and sex also leaves the findings subject to the influence of other factors, while the sample of 565 older adults limits the conclusions that can be generalized.

Overall, the study offers a mixed rather than uniformly protective picture. Stronger adherence to the combined Mediterranean lifestyle score was linked to lower odds of existing hypertension, but the score was not significantly associated with new hypertension, myocardial infarction or stroke during follow-up. Within the individual lifestyle components, Mediterranean diet adherence alone was associated with lower odds of a subsequent myocardial infarction, a result that warrants attention while remaining observational rather than causal.

Subject of Research: Observational associations of Mediterranean lifestyle and diet adherence with cardiovascular outcomes in older adults

Article Title: Associations between Mediterranean lifestyle and its components with cardiovascular outcomes among community-dwelling older adults

Article References: Coelho Júnior, H. J., & Marzetti, E. (2026). Associations Between Mediterranean Lifestyle and Its Components With Cardiovascular Outcomes Among Community-Dwelling Older Adults. Frontiers in Epidemiology, 6, 1933837. https://doi.org/10.3389/fepid.2026.1933837

Image Credits: AI Generated

DOI: 10.3389/fepid.2026.1933837

Keywords: Mediterranean lifestyle, Mediterranean diet, older adults, hypertension, myocardial infarction, stroke, cardiovascular outcomes, observational study, England, ELSA, Associations, between