Lifestyle Factors, Sociodemographic Characteristics and Incident Hypertension: A Prospective Analysis of the Korean National Health Insurance Service Sample Cohort

Abstract

Background: Hypertension is a significant chronic disease globally, and lifestyle modifications are crucial for the prevention of this disease. We conducted a longitudinal analysis of the associations between lifestyle factors and the incidence of hypertension, stratified by sociodemographic characteristics. Methods: We analyzed 113,022 adults (65,315 men), aged 20 years or older from the Korean National Health Insurance Service-National Sample Cohort 2.0 who participated in health screening between 2002 and 2003. Lifestyle factors (smoking, drinking, physical activity) were assessed at baseline using self reports, and incident hypertension was defined based on physician diagnoses. Cox proportional hazards regression models were used to assess associations. Results: During an 11.6-year follow-up, 26,812 new cases of hypertension were identified. The risk of hypertension was high among men and women who smoked over 20 cigarettes daily (men: hazard ratio [HR]: 1.15; 95% confidence interval [CI], 1.08–1.21; women: HR: 1.62; 95% CI 1.17–2.25) and those who drank over 1.5 bottles of alcohol daily (men, HR: 1.18; 95% CI, 1.12–1.24; women, HR: 1.23; 95% CI 1.02–1.47). These associations tended to be high in high-income men (HR: 1.09; 95% CI, 1.04–1.14), low-income women (HR: 1.19; 95% CI, 1.05–1.35) and non-obese women (HR: 1.13; 95% CI, 1.01–1.27) who currently smoked. Physical activity was inversely associated with incident hypertension in men (HR: 0.96; 95% CI, 0.93–0.99). Conclusions: Unhealthy lifestyle factors, such as heavy smoking and drinking, was associated with an increased risk of hypertension, with variations by income, BMI, and sex. These findings underscore the importance of tailored, population-specific prevention strategies to address hypertension disparities.