Clustering of risk factors and the risk of new-onset hypertension defined by the 2017 ACC/AHA Hypertension Guideline

• Published in: Journal of human hypertension Vol. 34; no. 5; pp. 372 - 377
• Main Authors: Huang, Yuli, Dai, Meng, Deng, Zhihui, Huang, Xingfu, Li, Hanlin, Bai, Yujia, Yan, Chuanjie, Zhan, Qiong, Zeng, Qingchun, Ouyang, Ping, Xu, Dingli
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2020; Nature Publishing Group
• Subjects: 692/499; 692/699/75/243; Blood Pressure; Body weight; Cardiology; Cardiovascular diseases; Cluster Analysis; Dextrose; Dyslipidemia; Epidemiology; Glomerular filtration rate; Glucose; Health Administration; Heart beat; Heart rate; Humans; Hypertension; Hypertension - diagnosis; Hypertension - epidemiology; Hyperuricemia; Medical screening; Medicine; Medicine & Public Health; Obesity; Overweight; Public Health; Risk Factors; United States - epidemiology; United States; China
• ISSN: 0950-9240; 1476-5527; 1476-5527
• DOI: 10.1038/s41371-019-0232-9

The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) lowered the diagnostic criteria for hypertension. We aimed to explore whether clustering of multiple risk factors are associated with the risk of new-onset hypertension defined by the 2017 ACC/AHA Hypertension Guideline. Subjects who attended ≥2 annual health examinations without baseline hypertension and cardiovascular disease were included. Hypertension was defined according to the 2017 ACC/AHA Hypertension Guideline. Seven predefined risk factors, including age, resting heart rate, overweight or obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and a poor estimated glomerular filtration rate, were analyzed. A composite, individual-level, cumulative score incorporating these seven risk factors (no = 0 point; yes = 1 point; total range of 0–7 points) was calculated. The association between the cumulative score and the risk of hypertension was analyzed using a Cox regression model. A total of 4424 (21.6%) of 20,190 subjects included had new-onset hypertension during a follow-up duration of 3.6 years. Compared with subjects with 0 points, the adjusted hazard ratios (95% confidence intervals) for the development of hypertension for those with 1, 2, 3, and ≥4 points were 1.21 (1.07–1.38), 1.34 (1.19–1.52), 1.44 (1.26–1.63), and 1.64 (1.44–1.87), respectively ( P  < 0.001), after adjustment for sex and baseline blood pressure. Age, resting heart rate, overweight/obesity, dyslipidemia, hyperuricemia, impaired glucose regulation, and a poor estimated glomerular filtration rate are associated with an increased risk of future hypertension. When these factors are combined, there is an accumulated increase in risk.