The role of lifestyle behaviour on the risk of hypertension in the SUN cohort: The hypertension preventive score

• Published in: Preventive medicine Vol. 123; pp. 171 - 178
• Main Authors: Díaz-Gutiérrez, Jesús, Ruiz-Estigarribia, Liz, Bes-Rastrollo, Maira, Ruiz-Canela, Miguel, Martin-Moreno, José M., Martínez-González, Miguel A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2019
• Subjects: Adult; Age Factors; Body Mass Index; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Cohort Studies; Diet, Mediterranean; Exercise - physiology; Female; Health Behavior; Healthy Lifestyle; Healthy lifestyle score; Humans; Hypertension; Hypertension - epidemiology; Hypertension - prevention & control; Linear Models; Longitudinal cohort study; Male; Middle Aged; Multivariate Analysis; Prevalence; Proportional Hazards Models; Prospective cohort study; Prospective Studies; Risk Reduction Behavior; Role; Sex Factors; Smoking - adverse effects; Smoking - epidemiology; Spain; Surveys and Questionnaires; Spain; Hypertension; Longitudinal cohort study; Healthy lifestyle score; Prospective cohort study
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2019.03.026

Lifestyles may influence the risk of hypertension. Our objective was to assess the association between a healthy-lifestyle score and the incidence of hypertension. The SUN Project is a dynamic, prospective cohort of Spanish university graduates (1999–2014). Among 14,057 participants initially free of hypertension, we assessed the influence of lifestyle-related factors based on a 10-item score that we previously reported to be associated with lower risk of major cardiovascular events. However, we focused on factors related to hypertension risk according to previous scientific evidence and international clinical guidelines and constructed a 6-item score including: no smoking, moderate-to-high physical activity, Mediterranean diet adherence, healthy body mass index, moderate alcohol intake and no binge drinking. We fitted Cox regression models to adjust for potential confounders. During a median follow-up of 10.2 years, we identified 1406 incident cases of medically diagnosed hypertension. The risk of developing hypertension was linearly reduced as participants better adhered to a healthy lifestyle pattern built by summing up these 6 factors (p for trend<0.001). The highest category (5–6 factors) exhibited a significant 46% relative reduction in the risk of developing hypertension compared to the lowest category (0–1 factors) (multivariable-adjusted hazard ratio = 0.54; 95% CI: 0.42–0.68). Among the components of the score, BMI was apparently the main factor driving the association between the HLS and lower risk of hypertension. A healthy-lifestyle score including six simple healthy habits was longitudinally and linearly associated with a substantially reduced risk of hypertension. This index may be a useful tool for hypertension prevention. •A healthy-lifestyle score was associated with a lower risk of incident hypertension.•BMI was apparently the key factor driving this association.•This score could be a simple tool to promote prevention of hypertension.