Traditional risk factors for essential hypertension: analysis of their specific combinations in the EPIC-Potsdam cohort

Abstract

Appropriate interventions might improve the prevention of essential hypertension. This requires a comprehensive view of modifiable lifestyle factors (MLFs) distribution and effect. To determine how six MLFs (general adiposity, abdominal adiposity, alcohol consumption, smoking, diet, physical inactivity) for risk of hypertension are distributed and how their combinations affect the risk, a prospective study cohort of 11,923 healthy participants from the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study was used. Of these, 1,635 developed hypertension during a mean follow-up of 10.3 years. Mutually exclusive combinations, clustering and interactions of MLFs were then investigated stratifying by sex, Hazard Ratios (HRs) and Population Attributable Risks (PARs%) were calculated. General adiposity alone was sufficient to increase the risk of hypertension (HR = 1.86, PAR% 3.36), and in this cohort it played a major role in enhancing the risk of hypertension, together with smoking and physical inactivity. MLFs had a different impact and a different modulation of risk in women and men, and they showed a remarkable tendency to occur in specific patterns with higher prevalence than expected. This indication can help to promote a holistic approach through multifactorial preventive strategies addressing more than a factor at a time. For prevention of hypertension addressing adiposity together with smoking, promoting at the same time physical activity should be the first choice.

Healthy lifestyle index and its association with hypertension among community adults in Sri Lanka: A cross-sectional study

“…This finding is similar to those of previous HLI studies that examined the associations between individual factors and hypertension [9][10][11][12][13]. This result also accords with those reported by Andriole et al [27], who investigated how combinations of six modifiable lifestyle factors (i.e., BMI, waist circumference, physical activity, smoking, alcohol consumption, and diet) are differentially linked with the incidence of hypertension in a large German cohort, and found that being overweight or obese (BMI �25 kg/m 2 ) contributed the most to hypertension risk among the six lifestyle factors. The present study adds to evidence that obesity plays a major role in the development of hypertension.…”

Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose–response meta-analysis

“…Although major final outcome of CVD such as death and cardiovascular disability do not occur in hypertensive children, they are encountered with increased risk of intermediate markers of target organ damage, such as left ventricular hypertrophy, retinal vascular changes, thickening of the carotid vessel wall, and even subtle cognitive changes [4]. It is widely recognized that blood pressure levels are influenced by genetic as well as by environmental factors [5,6]. In this regard, more than 90 different genetic polymorphisms have been identified to be associated with high blood pressure [7].…”

“…In this regard, more than 90 different genetic polymorphisms have been identified to be associated with high blood pressure [7]. For example, a recent study reported that polymorphism of aldosterone synthase gene is linked with the development of hypertension through increasing the aldosterone level and aldosterone/renin ratio [5]. On the other hand, among environmental parameters, obesity, smoking, alcohol consumption, diet, and physical inactivity likely play a major role in development of hypertension [6].…”

Knowledge, Attitudes, Practices and Blood Pressure Control of Hypertensive Patients at a South African Primary Health Care Centre

“…The implementation of such interventions requires an understanding of modifiable lifestyle factors. A study conducted in Germany in 2019 identified six well-recognised high-risk, modifiable lifestyle factors for hypertension [13]. General and abdominal adiposity, smoking and physical inactivity play important roles in increasing the risk of incidence and lack of control of hypertension.…”