Abstract MP87: Achieving Multiple Lifestyle Behaviour Targets Reduces the Risk of Hypertension in Adolescents

Abstract

Introduction: The benefits of achieving multiple lifestyle behaviour targets on cardiovascular disease risk, in adolescents, remains unclear. Hypothesis: We hypothesized that (1) achieving a composite of healthy lifestyle behaviour targets would be associated with a reduced risk of hypertension and (2) the relative risk reduction observed when multiple lifestyle behaviour targets were achieved would be greater than the sum of individual targets among adolescents. Design and Methods: We analysed data from a convenience sample of 394 adolescents 9-15 years enrolled in a 2-year prospective cohort study. The main exposure variable was a composite measure of achieving daily behavioural lifestyle targets for: (1) physical activity (>60 mins of MVPA daily-Actical Accelerometer); (2) fitness (>40th centile for age sex- 20m shuttle run test); (3) diet quality (meeting daily intake for food groups from Canada’s Food Guide to Healthy Eating: vegetables and fruits, grain products, milk and alternatives, and meats and alternatives); (4) sodium intake (<2.3g/day-24hr dietary recall); and (5) weight status (healthy weight status for age and sex-assessed directly using digital scale and stadiometer). The primary outcome was hypertension treated as a binary outcome (>90th centile for age, sex and height) measured in triplicate, seated, according to American Heart Association guidelines. Results: Hypertension developed in 13.7% (n=54) of youth at follow-up. Only 3% (n=13) of adolescents in the cohort met all 5 behavioural lifestyle targets. Hypertension was evident in 13.9% (n=53) of youth that did not meet all 5 lifestyle targets and 7.7% (n=1) of youth that did (OR: 0.51; 95% CI: 0.07-4.1). Achieving at least 3 behavioural targets was associated with a 67% reduced odds of hypertension (OR: 0.33; 95% CI: 0.16-0.68). In multivariate logistic regression analyses, healthy weight status was the only significant individual behavioural target associated with incident hypertension (OR: 0.17; 95% 0.08-0.38). Conclusion: Very few adolescents meet all current behavioural lifestyle targets for preventing cardiovascular disease. Achieving multiple lifestyle targets, particularly healthy weight status, is associated with a significantly reduced odds of hypertension among adolescents. Experimental trials, in adolescents, are needed to determine the efficacy of achieving multiple behavioural lifestyle targets for reducing cardiovascular risk factors, to confirm these observations.