Analysis of 83,248 UK Biobank participants with hypertension revealed that the DASH diet provided the strongest cardiovascular protection, reducing CVD risk by 15% and all-cause mortality by 22% when comparing highest versus lowest adherence quintiles. The study also found significant benefits from the Alternative Healthy Eating Index-2010 (9% CVD reduction) and reversed Empirical Dietary Inflammatory Pattern scores, while Mediterranean and plant-based diet indices showed weaker associations. Protective foods included vegetables, whole grains, nuts, legumes, fruits, and dairy, while sugar-sweetened beverages and meat consumption increased risk. This represents the largest dedicated analysis of dietary patterns specifically in hypertensive populations, filling a critical evidence gap since most nutrition research focuses on general populations. The findings suggest that dietary interventions remain highly relevant even after hypertension develops, challenging assumptions that medication alone suffices for cardiovascular protection. However, the observational design cannot establish causation, and the UK Biobank's demographic limitations may affect generalizability. The convergent evidence across multiple dietary indices strengthens confidence in the protective effects of whole foods, though the DASH diet's blood pressure-specific design appears particularly suited for this high-risk population.