title: Ideal cardiovascular health and incident hypertension: The longitudinal community-based Kailuan study.
abstract: Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the absence of disease and presence of 7 key health factors. Since it is unknown whether cumulative exposure to CVH reduces the risk of developing arterial hypertension, we prospectively examined the potential association between cumulative CVH (cumCVH) score (except for blood pressure metrics) and incident hypertension.Of the 101,510 participants with an age range of 18 to 98 years in this longitudinal community-based Kailuan study, our cohort included those 15,014 participants without hypertension at baseline and who had follow-up examinations 2, 4, and 6 years later. CumCVH was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (points × year). Based on the cumCVH score, the study population was stratified into groups of <44 points, 44 to 48 points, 49 to 54 points, 55 to 59 points, and ≥60 points.Incidence of hypertension ranged from 16.76% in the lowest cumCVH category to 11.52% in the highest cumCVH category. After adjusting for age, sex, education level, income level, high-sensitivity C-reactive protein concentration, uric acid concentration, resting heart rate, parental history of hypertension at baseline, and medication usage before the third follow-up examination, participants in the highest cumCVH category had a significantly reduced risk of incident hypertension compared with those in the lowest cumCVH category (adjusted odds ratio 0.60, 95% confidence interval 0.50-0.71). For every increase in category based on the cumCVH score, the risk of hypertension decreased by approximately 2% (odds ratio 0.98, 95% confidence interval 0.97-0.98). The effect was consistent across sex and age groups.A higher cumCVH score is associated with a lower risk of incident hypertension.
authors.affiliation: Department of Cardiology, Tianjin First Center Hospital, Clinical Medical College of Tianjin Medical University, Tianjin Department of Cardiology, Kailuan Hospital Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan Department of Neurology, Beijing Tiantan Hospital Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
authors.forename: Hai Yan
authors.initials: HY
authors.lastname: Zhao
authors.forename: Xiao Xue
authors.initials: XX
authors.lastname: Liu
authors.forename: An Xin
authors.initials: AX
authors.lastname: Wang
authors.forename: Yun Tao
authors.initials: YT
authors.lastname: Wu
authors.forename: Xiao Ming
authors.initials: XM
authors.lastname: Zheng
authors.forename: Xiao Hong
authors.initials: XH
authors.lastname: Zhao
authors.forename: Kai
authors.initials: K
authors.lastname: Cui
authors.forename: Chun Yu
authors.initials: CY
authors.lastname: Ruan
authors.forename: Cheng Zhi
authors.initials: CZ
authors.lastname: Lu
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
authors.forename: Shou Ling
authors.initials: SL
authors.lastname: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002320:Cardiovascular Physiological Phenomena; D002681:China; D015331:Cohort Studies; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D055815:Young Adult