Lifestyle, family history and progression of hypertension.
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.
Winnicki
Mikolaj
M
University of Padova, Padova, Italy.
Somers
Virend K
VK
Dorigatti
Francesca
F
Longo
Daniele
D
Santonastaso
Massimo
M
Mos
Lucio
L
Mattarei
Mauro
M
Pessina
Achille C
AC
Palatini
Paolo
P
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