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Multiple risk factor clustering of hypertension in a screened cohort
1Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan. tozawa@med.u-ryukyu.ac.jp
Insights
Clustering of hypertension risk factors significantly increases hypertension risk. The more risk factors, the higher the blood pressure in non-hypertensive individuals, highlighting the need for primary prevention.
Area of Science:
- Cardiovascular Health
- Epidemiology
- Public Health
Background:
- Family history of hypertension, obesity, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia are known hypertension risk factors.
- The impact of the clustering and accumulation of these risk factors on hypertension development and blood pressure levels requires further investigation.
Purpose of the Study:
- To evaluate if the clustering of hypertension risk factors increases hypertension risk.
- To determine if the accumulation of risk factors correlates with blood pressure levels in non-hypertensive individuals.
Main Methods:
- Assessed clinical data and family history of hypertension in 9914 individuals (18-89 years old) screened in Okinawa, Japan, in 1997.
- Utilized multivariate regression analyses to correlate the number of risk factors with blood pressure in non-hypertensive subjects, adjusting for age and sex.
Main Results:
- All five risk factors (hypertension history, obesity, diabetes, hypercholesterolemia, hypertriglyceridemia) were positively associated with hypertension.
- Odds ratios for hypertension increased significantly with the number of risk factors, from 1.88 for one factor to 24.48 for five factors, after adjustments.
- In non-hypertensive subjects, the number of risk factors positively correlated with both systolic (regression coefficient 1.96) and diastolic blood pressure (1.47).
Conclusions:
- Clustering of hypertension risk factors is significantly associated with increased hypertension risk.
- The accumulation of risk factors positively correlates with blood pressure levels in non-hypertensive individuals.
- Addressing the aggregation of risk factors is crucial for primary hypertension prevention efforts.
Objective:
A family history of hypertension, obesity, diabetes mellitus, hypercholesterolaemia and hypertriglyceridaemia have all been associated with the risk for hypertension. We evaluated whether the clustering of these risk factors increases the risk for hypertension or whether the accumulation of risk factors is associated with the blood pressure level in non-hypertensive subjects.
Methods And Subjects:
We assessed the clinical data and family history of hypertension (in parents and siblings) for 9914 individuals (6163 men and 3751 women, 18-89 years old) who were screened in Okinawa, Japan, in 1997.
Results:
In 9914 subjects (2465 hypertensive and 7449 non-hypertensive subjects), all the five factors were positively associated with hypertension. The odds ratios (95% confidence interval) for the number of risk factors were 1.88 (1.62-2.18) for one risk factor, 3.06 (2.62-3.57) for two, 5.25 (4.37-6.30) for three, 8.71 (6.48-11.72) for four and 24.48 (8.49-70.56) for five, after adjusting for age, sex, alcohol consumption, cigarette smoking and physical exercise habits. In non-hypertensive subjects, multivariate regression analyses showed that the number of risks was positively correlated with blood pressure; the regression coefficient was 1.96 (P < 0.0001) for systolic blood pressure, and 1.47 (P < 0.0001) for diastolic blood pressure after adjusting for age and sex.
Conclusions:
Clustering of risk factors was significantly associated with hypertension. The number of risk factors positively correlated with the blood pressure levels in nonhypertensive subjects. The accumulation of risk factors may play an important role in the pathogenesis of hypertension, and thus the aggregation of risk factors may need to be addressed in primary prevention efforts related to hypertension.