Physical disability and risk of incident hypertension: a prospective cohort analysis

Hypertension remains a leading cause of morbidity and mortality worldwide, yet its relationship with physical disability has been underexplored in population-based longitudinal studies. We conducted a prospective cohort analysis using data from the UK Household Longitudinal Study. Individuals aged 16 and older without baseline hypertension (N = 19,319) were followed from Wave 10 (2018-19) to Wave 14 (2022-23). Physical disability was defined as self-reported difficulty, lasting or expected to last at least 12 months, in any of eight domains of physical and sensory functioning. Modified Poisson regression with robust standard errors was used to estimate adjusted relative risks (RRs) for incident hypertension, controlling for age group, sex, residential location (urban/rural), educational attainment, ethnicity, smoking status, and baseline health conditions. Over a four-year follow-up, 610 of 19,319 participants (3.2%) developed hypertension. In fully adjusted model, individuals with any physical disability had a significantly elevated risk of hypertension (RR = 1.65; 95% CI:1.39-1.97; p < 0.001) compared to those without disability. Compared to individuals with no disability, those with one physical disability had an RR of 1.29 (95% CI:1.01-1.64; p = 0.043), while those with two or more disabilities had an RR of 2.10 (95% CI:1.69-2.59; p < 0.001). A linear trend was observed across increasing number of disabilities (RR per additional domain = 1.43; 95% CI:1.29-1.59; p < 0.001). By type, the highest risks were observed for coordination or balance impairment (RR = 2.12; 95% CI:1.58-2.84), mobility impairment (RR = 2.03; 95% CI:1.66-2.48), and sight impairment (RR = 1.80; 95% CI:1.27-2.56), all p < 0.001. Physical disability was a significant independent predictor of incident hypertension in this population-based cohort.