Inverse association between dietary oxidative balance score and myocardial infarction in hypertensive patients: A cross-sectional study based on NHANES 1999–2018

Objective Hypertension is a major risk factor for myocardial infarction. However, the association between the dietary oxidative balance score and myocardial infarction risk among individuals with hypertension remains unclear. This study aimed to investigate the relationship between dietary oxidative balance score and the risk of myocardial infarction in hypertensive adults. Methods In this cross-sectional study, we analyzed data from 14,137 hypertensive participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Dietary oxidative balance score was calculated based on the intake of 16 dietary components, including 14 antioxidants and two pro-oxidants. Logistic regression models were used to assess the association between dietary oxidative balance score and myocardial infarction, and restricted cubic splines were applied to explore potential nonlinear relationships. Results A significant inverse association was observed between dietary oxidative balance score and myocardial infarction risk. In the fully adjusted model, each one-point increase in dietary oxidative balance score was associated with a 2.4% reduction in the odds of myocardial infarction (OR: 0.976; 95% CI: 0.966–0.985). Compared to the lowest tertile, participants in the highest dietary oxidative balance score tertile had a 28.9% lower risk of myocardial infarction (OR: 0.711; 95% CI: 0.609–0.831). Although nonlinearity was not statistically significant, a threshold effect was observed, with the most pronounced risk reduction at lower dietary oxidative balance score levels. Conclusion Higher dietary oxidative balance score values were associated with a reduced risk of myocardial infarction in hypertensive patients. These findings suggest that dietary patterns emphasizing oxidative balance may serve as an effective strategy for myocardial infarction prevention in high-risk populations.