Protective Health Factors and Incident Hypertension in Men

Abstract

Few studies have investigated the association between a combination of lifestyle factors and the incidence of hypertension, particularly in men. This is important as lifestyle factors are often interrelated, and may often occur in combination. Examining this association would lead to a better understanding of the etiology of hypertension, and has the potential to contribute to improved prevention strategies. PURPOSE: To investigate the individual and combined effects of body mass index (BMI), smoking status, alcohol intake, physical activity, and cardiorespiratory fitness on the incidence of hypertension in men. METHODS: A total of 14,568 men (M age = 44.0 ± 9.3 years) from the Aerobics Center Longitudinal Study initially free of hypertension completed an extensive baseline examination during 1974 - 2003, and were followed for the incidence of hypertension. A protective health profile was characterized by the following factors: light alcohol consumption, physically activity, physically fit, normal BMI, and not a current smoker. Based on criteria met, categories of 0 through 5 combined protective health factors were formed. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models adjusting for covariates. Population attributable risk of hypertension was estimated for the 5 protective health factors. RESULTS: A total of 1,959 men reported developing hypertension during a mean of 10.7 ± 7.6 years of follow-up. Our data indicated that a combination of 5 protective health factors significantly reduced the risk of hypertension by 51% (95% CI: 29 - 66%). We also found that if all participants in our sample had 5 protective health factors, the incidence of hypertension would be expected to have decreased by 26% (95% CI: 11 - 38%). Additionally, having a normal BMI (HR: 0.70; 95% CI: 0.64 - 0.77) and being a non smoker (HR: 0.71; 95% CI: 0.63 - 0.79), physically active (HR: 0.87; 95% CI: 0.79 - 0.96), and physically fit (HR: 0.72; 95% CI: 0.65 - 0.79) was significantly and independently associated with a lower risk of developing hypertension. CONCLUSIONS: Our results show that among men aged 20 to 82 years, a combination of healthy lifestyle factors can significantly reduce the risk of developing hypertension, and should be considered for the prevention of this chronic condition.