title: Lifestyle, family history and progression of hypertension.
abstract: BACKGROUND
  Unhealthy lifestyle practices are risk factors for future hypertension.
  
  
  OBJECTIVE
  The aim of this study was to investigate the association between lifestyle changes over a 6-year period and the risk of developing sustained hypertension in a cohort of young hypertensive individuals, and to identify the predictors of lifestyle impairment over time.
  
  
  METHODS
  Seven-hundred and eighty never-treated hypertensive HARVEST participants, 18-45 years old, were studied.
  
  
  RESULTS
  Only modest mean behavioral changes were observed during follow-up. This, however, was the net result of many participants improving and others worsening their lifestyle. Participants with a family history of hypertension (FH+, n = 459) had more undesirable lifestyles (P = 0.004) and higher clinic and ambulatory blood pressures (P = 0.03) at baseline than participants without a family history of hypertension (FH-). During the 6-year follow-up, FH- individuals strikingly worsened their lifestyle while FH+ participants exhibited impressive improvements (P < 0.00001). Other predictors of lifestyle impairment were male gender (P = 0.003) and age (P = 0.02). Adoption of an unfavorable lifestyle was accompanied by an increased risk of developing sustained hypertension (P = 0.04). Initiation of drug therapy for hypertension was significantly higher among FH- than FH+ individuals (53 versus 45%, respectively; P = 0.045).
  
  
  CONCLUSIONS
  'Lower risk' FH- stage 1 hypertensive individuals may initially be at higher risk of developing more severe hypertension in comparison with their FH+ counterparts. This increased risk may be attributed to worsening of their lifestyle profiles over time. Healthy lifestyles should be emphasized to all hypertensive individuals including patients with favorable lifestyle profiles.
authors.affiliation: University of Padova, Padova, Italy.
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Winnicki
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.forename: Francesca
authors.initials: F
authors.lastname: Dorigatti
authors.forename: Daniele
authors.initials: D
authors.lastname: Longo
authors.forename: Massimo
authors.initials: M
authors.lastname: Santonastaso
authors.forename: Lucio
authors.initials: L
authors.lastname: Mos
authors.forename: Mauro
authors.initials: M
authors.lastname: Mattarei
authors.forename: Achille C
authors.initials: AC
authors.lastname: Pessina
authors.forename: Paolo
authors.initials: P
authors.lastname: Palatini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002940:Circadian Rhythm; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D007558:Italy / Q000208:ethnology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D044465:White People