Risk Of New-onset Hypertension Research Articles

Vitamin D and the Risk of Developing Hypertension in the SUN Project: A Prospective Cohort Study.

Vitamin D deficiency has been associated with a higher risk of multiple diseases, including cardiovascular disorders. The purpose of this study was to examine the potential association between predicted levels of serum 25(OH)D and the risk of new-onset hypertension in a large Mediterranean cohort. A validated 136-item food frequency questionnaire was used as the dietary assessment tool. 25(OH)D serum levels were predicted using a previously validated equation. We performed Cox regression models to analyze the association between predicted serum 25(OH)D and the risk of hypertension, according to quartiles of forecasted vitamin D at baseline, after adjusting for multiple potential confounders. Over a median follow-up of 12.3 years, 2338 new cases of hypertension were identified. The analyses revealed a significant inverse association between predicted serum levels of 25(OH)D at baseline and the risk of hypertension. Individuals in the highest quartile showed a 30% relatively lower risk of hypertension compared to the lowest quartile (hazard ratio (HR): 0.70; 95% confidence interval (CI): 0.60-0.80, p-trend < 0.001). The outcomes remained significant after performing sensitivity analyses. The findings suggested that higher levels of forecasted vitamin D are inversely and independently associated with the risk of incident hypertension, implying that vitamin D may offer protective benefits against the disease.

Risk of new-onset hypertension in patients (pts) with newly diagnosed chronic lymphocytic leukemia (CLL) treated with Bruton tyrosine kinase inhibitors (BTKi): A real-world data study using the Symphony Health Solution database.

e19014 Background: BTKis provide an important therapeutic option for pts diagnosed with CLL. Concerns have arisen about a potential association with the risk of cardiovascular events with BTKi. Using the Symphony Health Solutions database, this study describes the risk of new-onset hypertension in CLL pts treated with and without BTKis. Methods: Newly diagnosed CLL pts who started ibrutinib or acalabrutinib and those not treated with an approved BTKi between 2019 and 2022 were included in the analysis. The prevalence of hypertension prior to and risk of new-onset hypertension after treatment initiation were defined by use of antihypertensive medication. Pt demographics and comorbidities were described. Multivariate regression and inverse probability treatment weight based on propensity score were used to account for bias due to differences in pt characteristics between groups. Results: In CLL pts treated with (n=7,114) and without BTKis (n=34,571), demographics and clinical characteristics included age at the index date (mean: 70.2 yrs, BTKi; 69.0 yrs, without BTKi), sex (male: 59.8%, BTKi; 55.7%, without BTKi), and Charlson comorbidity scores (mean: 3.3, BTKi; 3.1, without BTKi). At baseline, the prevalence of hypertension defined by the use of antihypertensive medication was 67.8% with BTKi and 67.6% without BTKi. Among pts without any antihypertensive medication use at baseline, the rates of new-onset hypertension within 1 yr after treatment initiation were greater in pts with BTKis than without BTKis (Table). Conclusions: In this real-world analysis, CLL pts treated with BTKis had a higher burden of comorbidities, and use of antihypertensive medication was common. The risk of new-onset hypertension was higher in pts initiated on BTKis than those on non-BTKi treatments. These data suggest that development of hypertension is an important consideration in the long-term management of CLL pts undergoing BTKi treatment. [Table: see text]

Circulating metabolic biomarkers and risk of new-onset hypertension: findings from the UK Biobank.

The evidence regarding the associations of circulating metabolic biomarkers with hypertension risk is scarce. We aimed to examine the associations between circulating metabolites and risk of hypertension. We included 49 422 individuals free of hypertension at baseline with a mean (SD) age of 53.5 (8.0) years from the UK Biobank. Nuclear magnetic resonance spectroscopy was used to quantify 143 individual metabolites. Multivariable-adjusted Cox regression models were used to estimate hazard ratios and 95% confidence intervals (CIs). During a mean (SD) follow-up of 11.2 (1.8) years, 2686 incident hypertension cases occurred. Out of 143 metabolites, 76 were associated with incident hypertension, among which phenylalanine (hazard ratio: 1.40; 95% CI: 1.24-1.58) and apolipoprotein A1 (hazard ratio: 0.76; 95% CI: 0.66-0.87) had the strongest association when comparing the highest to the lowest quintile. In general, very-low-density lipoprotein (VLDL) particles were positively, whereas high-density lipoprotein (HDL) particles were inversely associated with risk of hypertension. Similar patterns of cholesterol, phospholipids, and total lipids within VLDL and HDL particles were observed. Triglycerides within all lipoproteins were positively associated with hypertension risk. Other metabolites showed significant associations with risk of hypertension included amino acids, fatty acids, ketone bodies, fluid balance and inflammation markers. Adding 10 selected metabolic biomarkers to the traditional hypertension risk model modestly improved discrimination (C-statistic from 0.745 to 0.752, P < 0.001) for prediction of 10-year hypertension incidence. Among UK adults, disturbances in metabolic biomarkers are associated with incident hypertension. Comprehensive metabolomic profiling may provide potential novel biomarkers to identify high-risk individuals.

The Association between the Diversity of Coenzyme Q10 Intake from Dietary Sources and the Risk of New-Onset Hypertension: A Nationwide Cohort Study.

Coenzyme Q10 (CoQ10) is a food active component with blood-pressure-improving properties. However, the association between the variety and quantity of different sources of dietary CoQ10 and new-onset hypertension remains uncertain. We aimed to investigate the associations between the diversity and quantity of CoQ10 intake from eight major food sources and new-onset hypertension risk. A total of 11,489 participants were included. Dietary intake was evaluated via three consecutive 24 h recalls and household food inventory. The diversity score of CoQ10 sources was calculated by the sum of food groups consumed in the ideal range. Cox proportional hazard models were used for evaluating their associations with hypertension. Model performance was assessed by ROC analyses and 200-times ten-fold cross-validation. The relationships between CoQ10 and hypertension were U-shaped for meat, egg, vegetable, and fruit sources, inverse J-shaped for fish, and nut sources, and L-shaped for dairy products sources (all p-values < 0.001). A higher diversity score was associated with lower hypertension risk (HR (95% CI): 0.66 (0.64, 0.69)). The mean areas under the ROC curves for 6, 12 and 18 years were 0.81, 0.80 and 0.78, respectively. There is a negative correlation between the diversity of CoQ10 with moderate intake from different sources and new-onset hypertension. One diversity score based on CoQ10 was developed.

Association of TyG index and central obesity with hypertension in middle-aged and elderly Chinese adults: a prospective cohort study

Triglyceride glucose index (TyG) and waist circumstance have been well documented to be highly correlated with hypertension. However, the joint effect of waist circumstance and TyG on the risk of hypertension is unknown in middle-aged and elderly Chinese adults. The purpose of this study was to investigate the association between TyG and the risk of new-onset hypertension in middle-aged and elderly Chinese individuals with different waist circumstances. The multicentred prospective cohort study was conducted in 28 provinces of China including a total of 5865 eligible participants aged ≥ 45 years old. Cox regression was performed to examine the relationship of TyG index and hypertension with adjustments for the pertinent variables. Besides, the relationship was explored in different groups on the basis of waist circumstance. There was no significant correlation between TyG index and new-onset hypertension after adjustment for pertinent variables (hazards ratio [HR]: 0.99; 95% confidence interval [CI]: 0.80–1.24). When the association was explored in different waist circumstance groups, multivariate cox regression analyses revealed that TyG was an independent factor positively associated with the risk of hypertension in central obesity prophase group (HR: 1.57; 95% CI 1.13–2.16). Among individuals with central obesity, relative to population with lower TyG (Q1: 4.96–8.18), people who had higher TyG (Q3: 8.52–8.95; Q4: 8.95–12.14) were associated with significantly lower HR for hypertension. There was no conspicuous correlation between TyG index with new-onset hypertension in normal waist circumstance (HR: 1.05; 95% CI 0.84–1.30). The research demonstrated the positive relationship of TyG with risk of hypertension among individuals with central obesity prophase, negative relationship of TyG with hypertension among population with central obesity and inconspicuous correlation of TyG with hypertension among individuals with normal waist. In conclusion, the study findings supported the combined effects of TyG index and waist circumference in predicting hypertension in middle-aged and elderly Chinese individuals.

The positive association between the atherogenic index of plasma and the risk of new-onset hypertension: a nationwide cohort study in China

ABSTRACT Background The atherogenic index of plasma (AIP) is a novel metabolic biomarker of atherosclerosis. Nevertheless, the association between the AIP and new-onset hypertension has not been elucidated in the Chinese population. Methods Prospective data were obtained from 3150 participants aged ≥ 18 years in the China Health and Nutrition Survey from 2009 to 2015. The AIP is a logarithmically transformed ratio of triglycerides to high-density lipoprotein cholesterol in molar concentration. Cox regression analysis was used to determine the association of AIP index with new-onset hypertension. Results After the six-year follow-up, 1054 (33.4%) participants developed new-onset hypertension. The participants were divided into AIP quartile groups (Q1-Q4). Compared with those in Q1, subjects in Q3–4 had nearly 1.35 times the risk of new-onset hypertension after full adjustment [Q3: hazard ratio (HR): 1.35, 95% confidence interval (CI): 1.13–1.62; Q4: HR: 1.35, 95% CI: 1.13–1.64]. The risks of new-onset hypertension were nearly 1.30 times higher in subjects in Q2–4 than in subjects in Q1 (p < .01) after the full adjustment when we excluded subjects with diabetes and/or chronic kidney diseases. There was a significant difference [HR (CI): 1.27 (1.04–1.54) vs. 0.90 (0.69–1.18)] when subjects were divided into two groups according to body mass index (BMI) level (<24 vs. ≥24 kg/m2). Conclusions The present study suggested that individuals with a higher AIP index are associated with new-onset hypertension, independent of kidney function and glucose levels. The association was stronger in subjects with normal BMI, which may provide early screening of metabolomics in hypertension prevention.

Plasma Calprotectin Levels Associate With New-Onset Hypertension in the General Population: A Prospective Cohort Study.

Low-grade systemic inflammation is a relevant pathogenic mechanism underlying the development of hypertension. In this study, we hypothesized that plasma calprotectin levels, as a biomarker of neutrophil-mediated inflammation, is associated with developing new-onset hypertension in the general population. Plasma calprotectin levels were determined in 3524 participants who participated in the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study, a prospective population-based cohort study. Plasma calprotectin levels were studied for associations with the risk of new-onset hypertension, defined as systolic blood pressure of at least 140 mm Hg, diastolic blood pressure of at least 90 mm Hg, or the first recorded use of antihypertensives. Participants with hypertension at baseline were excluded. Median plasma calprotectin levels were 0.48 (0.34-0.66) mg/L, and median systolic blood pressure was 117 (109-126) mm Hg. Plasma calprotectin levels were significantly associated with the risk of new-onset hypertension (hazard ratio [HR], per doubling 1.30 [95% CI, 1.21-1.41]; P<0.001), also after adjustment for age and sex (HR, 1.26 [95% CI, 1.16-1.37]; P<0.001), but not after additional adjustment for potentially confounding factors, including baseline systolic blood pressure (HR, 1.00 [95% CI, 0.90-1.11]; P=0.996). Stratified analyses showed significant effect modification by sex (Pinteraction=0.023) and urinary albumin excretion (Pinteraction=0.004), with higher HRs in men (compared with women) and in individuals with higher urinary albumin excretion (>9.3 mg per 24 hours) compared with lower urinary albumin excretion (≤9.3 mg per 24 hours). Higher plasma calprotectin levels are associated with an increased risk of new-onset hypertension in the general population. This association is dependent on baseline systolic blood pressure and is particularly prominent in men compared with women.

There was a similar U-shaped nonlinear association between waist-to-height ratio and the risk of new-onset hypertension: findings from the CHNS.

The association between waist-to-height ratio (WHtR) with hypertension has not been adequately explained, so in this study we sought to clarify the predictive role of WHtR on the incidence of hypertension as well as the potential nonlinear associations in the general population. In this large prospective cohort study, a total of 4,458 individuals from the China Health and Nutrition Survey (CHNS) were included in the analysis. Multivariate Cox regression analyses, subgroup analyses, receiver operator characteristic (ROC) and restricted cubic spline (RCS) analyses were used to examine the association of WHtR with the risk of new-onset hypertension. Hypertension occurred in 32.8% of participants during the maximum six-year follow-up period. Compared with the group with lower WHtR, the group with higher WHtR had a higher incidence of hypertension (p < 0.001). Multivariate Cox regression analysis showed that the risk of hypertension was 1.45 times higher in the high WHtR group than in the low WHtR group, and that the risk of hypertension increased by 30.4% for every 0.1 unit increase in WHtR (p < 0.001). Subgroup analyses also validated the stratified associations between WHtR and the risk of new-onset hypertension in most subgroups (p < 0.05). ROC analyses also revealed that WHtR was superior to body mass index in predicting new-onset hypertension (AUC: 0.626 vs. 0.607, p = 0.009). Further RCS analysis detected a nonlinear association between WHtR and risk of new-onset hypertension (P for nonlinearity <0.001). WHtR was nonlinearly associated with the risk of new-onset hypertension in the general population.

Increased Risk of Hypertension Onset Among Patients With Narcolepsy Newly Treated With High-Sodium Oxybate (P5-13.002)

Increased Risk of Hypertension Onset Among Patients With Narcolepsy Newly Treated With High-Sodium Oxybate (P5-13.002)

JS-ISH-ESH-1: DRUGS AND SUBSTANCES THAT INCREASE BLOOD PRESSURE

The use of herbal medications and substances that have been touted to raise BP is increasing globally with estimates for example 6 to 48 percent of persons use herbal therapies in Europe. Other medications such as NSAIDs are among the most widely used treatments globally. Several of such medications and substances may raise blood pressure or antagonize the BP lowering effects of antihypertensive therapy in individuals. The individual effect of these substances on blood pressure can be highly variable with greater increases noted in the elderly, those with higher baseline blood pressure, use of antihypertensive therapy, and co-existing renal disease. In this discussion, we will review the evidence for the most commonly implicated substances that have been considered to raise blood pressure including NSAIDs, oral contraceptives, hormone replacement therapy, and antidepressants. We will also review the evidence for herbal therapies that may raise BP. Coxibs are associated with a 3.9 mm Hg mean increase in SBP and nonselective NSAIDs 2.8 mm Hg compared with placebo. In meta-analyses, aspirin was not associated with a significant blood pressure increase. High regular acetaminophen dosing is associated with an increased risk of new onset hypertension. Oral contraceptives were associated with new onset hypertension in approximately 5 percent of users of high dose compounds that contain at least 50 mg estrogen but these high estrogen doses are not commonly used in current formulations. SNRI antidepressants were found to have a small increase in systolic blood pressure relative to SSRI antidepressants 1.5 mmHg. Patients prescribed SSRIs showed no significant differences in blood pressure changes compared with placebo. Despite their widespread use, there are few studies on the effects of herbal substances on blood pressure apart from licorice and ephedra or ma huang. Licorice contains glycyrrhizic acid that acts as an 11 beta hydroxysteroid dehydrogenase type 2 inhibitor causing pseudohyperaldosteronism. Given the widespread use of these medications and substances, physicians will have to screen for these medications and substances when assessing patients at risk for and with hypertension.

PS-BPP05-5: HIGH LEVELS OF FATTY LIVER INDEX PREDICT NEW-ONSET HYPERTENSION WITH DYSGLYCEMIA

Objective: To investigate whether the fatty liver index (FLI) predicts the development of hypertension in individuals with and without dysglycemia in the general Japanese population. Design and method: A total of 3114 participants including 1036 men and 2078 women who received specific health checkups in 2013 were observed until 2018. We defined dysglycemic as impaired fasting glucose (IFG) and diabetes mellitus. The participants were divided into 6 groups based on FLI tertile by sex and whether they had dysglycemia. The data was analyzed using the Cox proportional hazard model to calculate adjusted hazard ratios (HR) for the incident of hypertension. The model was adjusted for age, low-density lipoprotein, high-density lipoprotein, smoking and alcohol drinking, and further adjusted for systolic blood pressure (SBP) at baseline. Results: During a five-year follow-up period, a total of 853 of the 3114 participants had new onset hypertension. Using the low FLI group with normoglycemia as a reference, the risk of developing hypertension was significantly elevated in the high FLI group with normoglycemia, after confounders except for SBP, in male and female [HR (95% CI) male: high, 1.52 (1.06–2.17); female: high, 1.86 (1.43–2.42)], and also, in the high FLI group with dysglycemia, the risk was significantly elevated [male: low, 1.11(0.71–1.74); moderate, 1.58(1.05–2.39); high, 2.05(1.43–2.92); female: low, 1.56(0.97–2.49); moderate, 1.06(0.65–1.71); high, 2.98(2.19–4.07)]. After adjusting for SBP, the significance disappeared in high FLI with normoglycemia among male. meanwhile it remained unchanged in high FLI with normoglycemia in female and in high FLI with dysglycemia in male and female, respectively. Conclusions: Our study showed that FLI was independently associated with the risk of new-onset hypertension with or without dysglycemia. It suggests high FLI population, even in normoglycemia, should be managed for prevention of hypertension. The risk of developing hypertension was more pronounced in the dysglycemic population with high FLI, which may help predict subjects at high risk of developing hypertension in the dysglycemic population.

J-Shaped Association of Tomato Intake with New-Onset Hypertension in General Adults: A Nationwide Prospective Cohort Study.

We aim to examine the prospective association between the intake of dietary tomatoes and the risk of new-onset hypertension and its modifiable factors in general adults. A total of 11,460 adults without hypertension from the China Health and Nutrition Survey (CHNS) were enrolled, with follow-up beginning in 1997 and ending in 2015. Dietary tomato intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or diagnosed by physicians or under anti-hypertensive treatment during the follow-up. Finally, 4015 subjects developed new-onset hypertension during 92,335.5 person-years of follow-up. After multivariate adjustment for dietary and non-dietary risk factors, hazard ratios for increased consumption of dietary tomatoes were 0.42 (95% confidence interval, 0.37−0.47), 0.51 (0.46−0.57), and 0.82 (0.74−0.92) compared with non-consumers. Overall, cubic spline regression suggested a novel J-shaped association between dietary tomato intake and new-onset hypertension, with the lowest risk observed at approximately 10 to 13 g/day (p < 0.001 for curvature). Moreover, the association between dietary tomato intake and risk of new-onset hypertension was stronger in females or individuals who refrained from smoking or drinking (p = 0.024, p = 0.043, and p = 0.044 for interaction, respectively).

The association of high-sensitivity C-reactive protein with new-onset hypertension in different age groups

Objective: To investigate the association between high sensitivity C-reactive protein (hsCRP) level and new-onset hypertension in different age groups. Methods: This was a prospective cohort study involving non-hypertensive population in Kailuan Group community who participated in health examination between 2006 and 2007.Follow-up was conducted every 2 years, and the time of new onset of hypertension was used as the endpoint of follow-up. The endtime of follow-up for patients without hypertension was the time of death or the last follow-up (December 31, 2017).According to the baseline hsCRP level, the participants were divided into low-risk group (hsCRP<1.0 mg/L), medium-risk group (hsCRP ≥1.0 and ≤3.0 mg/L), and high-risk group (hsCRP>3.0 mg/L), and further stratified by age. Kaplan-Meier method was used to calculate the cumulative incidence of hypertension in each group. Multivariate Cox regression model was used to analyze the association between hsCRP level and new-onset hypertension. Results: A total of 51 179 participants were included in this study, including 38 606 males (75.43%) with an average age of (48.1±12.2) years. The baseline hsCRP was 0.64 (0.25, 1.60) mg/L. The baseline hsCRP was 0.30 (0.16, 0.59), 1.57 (1.20, 2.10), 5.17 (3.80, 7.10) mg/L respectively in low-, medium- and high-risk groups. During the follow-up of (8.1±2.2) years, a total of 9 523 (18.60%) patients developed hypertension, and the cumulative incidence rates of low-, medium- and high-risk groups were 17.41%, 20.48% and 20.73%, respectively. The cumulative incidence of hypertension in low-, medium- and high-risk groups of<45, 45-54, 55-64, ≥65 years old were 13.53%, 15.82%, 16.76%; 19.27%, 22.84%, 21.62%; 21.55%, 24.19%, 24.88%;20.20%, 22.35%, 19.11%, respectively. Except for people aged ≥65 years, there were significant differences in the cumulative incidence of hypertension in low-, medium- and high-risk groups (all P<0.05).Multivariate Cox regression analysis showed that the risk of new-onset hypertension in the high risk group was 1.11 times higher than that in the low risk group (HR=1.11, 95%CI 1.05-1.18). The risk of new-onset hypertension in the high-risk group was 1.22 times (HR=1.22, 95%CI 1.08-1.38), 1.14 times (HR=1.14, 95%CI 1.04-1.26), 1.16 times (HR=1.16, 95%CI 1.04-1.30), and 1.02 times (HR=1.02, 95%CI 0.86-1.20) of the low-risk group, in the<45, 45-54, 55-64, and ≥65 years old groups, respectively. Conclusion: Higher hsCRP level is a risk factor for new-onset hypertension, and the risk of developing hypertension caused by elevated hsCRP is age-dependent.

U-Shaped Relation of Dietary Thiamine Intake and New-Onset Hypertension.

Background: To examine the relation of dietary thiamine intake with risk of new-onset hypertension in the general adults. Methods: A total of 12,177 participants without hypertension at baseline from China Health and Nutrition Survey (CHNS) were included. The study outcome was new-onset hypertension, which was defined as a systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg or under antihypertensive treatment or diagnosed by physician during the follow-up. Results: A total of 4269 participants occurred new-onset hypertension over a median follow-up of 6.1 years. Overall, there was a U-shaped relation (p for nonlinearity <0.001) of dietary thiamine intake with new-onset hypertension, with an inflection point at 0.93 mg/day. Accordingly, in the threshold effect analysis, there was an inverse association between dietary thiamine intake (per SD increment: HR, 0.62; 95% CI: 0.53, 0.72) and new-onset hypertension in participants with dietary thiamine intake <0.93 mg/day, and a positive association between dietary thiamine intake (per SD increment: HR, 1.38; 95% CI: 1.32, 1.44) and new-onset hypertension in those with dietary thiamine intake ≥0.93 mg/day. Conclusion: The association between dietary thiamine intake and the risk of new-onset hypertension followed a U-shaped relation in the general Chinese population, with an inflection point at 0.93 mg/day of dietary thiamine intake.

Indoor air quality and the risk of hypertension.

Indoor air quality and the risk of hypertension.

Impact of lifestyle and psychosocial factors on the onset of hypertension after the Great East Japan earthquake: a 7-year follow-up of the Fukushima Health Management Survey.

Natural disasters force many evacuees to change several aspects of their lifestyles. This longitudinal study aimed to investigate whether factors such as living environment and lifestyle factors were related to new-onset hypertension in survivors of the Great East Japan Earthquake over a long-term follow-up of up to 7 years after the earthquake. The present study examined data collected from 29,025 Japanese participants aged 39-89 years, sourced from general health checkups and the Fukushima Mental Health and Lifestyle Survey, which was conducted in 13 communities between 2011 and 2018. A total of 10,861 participants received follow-up examinations. During a median follow-up of 4.3 years, 3744 participants (1588 men, 41.4%; 2,156 women, 30.7%) had newly developed hypertension. Heavy drinking (adjusted hazard ratio 1.38, 95% confidence interval 1.21-1.57, p < 0.001) and obesity (adjusted hazard ratio 1.27, 95% confidence interval 1.19-1.37, p < 0.001) were significantly associated with new-onset hypertension after the disaster in multivariate-adjusted analysis. Furthermore, experiencing evacuation after the disaster was also significantly associated with the risk of new-onset hypertension in men (adjusted hazard ratio 1.14, 95% confidence interval 1.02-1.27, p = 0.016). The present study indicated that lifestyle factors, such as drinking and obesity, and evacuation experience in men had significant effects on the risk of new-onset hypertension in the long term after the earthquake.

Does severe subacute noise exposure increase risk of new onset hypertension beyond conventional risk factors? A 30 000 person-years cohort study.

Objectives:Previous studies mostly focused on the relationship between chronic environmental noise exposure and hypertension but the effects of subacute (under 4 years) exposure with severe (>85 dB) noise exposure on clinical level hypertension have not been explored. This study aimed to reveal the association between severe noise exposure and hypertension.Methods:The severe noise exposure group was recruited from a Common Data Model conducted for the Korean Participants Health Examination from January 2014 to December 2017. The use of antihypertensive drug and/or blood pressure of at least 140/90 mmHg was defined as new onset clinical hypertension. A multivariate Cox proportional hazard model was implemented to estimate hazard ratios and 95% confidence intervals (CI) by adjusting covariates including demographic, lifestyle, and other chemical exposure factors. Time-dependent Cox analysis and Landmark analysis were further performed as a sensitivity analysis.Results:During the 29 332 person-years follow-up with 12 412 participants of the entire cohort, new onset hypertension occurred in 1222 participants. The findings showed that severe noise exposure was associated with an increased risk of hypertension incidence in the entire cohort [final model hazard ratio 1.28 (95% CI 1.11–1.47)]. Other covariates did not attenuate the association after adjusting age and sex. Time-dependent Cox and Landmark analysis also showed significant results [hazard ratio 1.60 (95% CI 1.38–1.85) and hazard ratio 1.33 (95% CI 1.13–1.57)].Conclusion:Severe noise with subacute exposure is significantly associated with hypertension development. Further studies should be implemented to clarify whether severe exposure to noise could be an important risk factor for hypertension.

Abstract 10026: Higher Odds of Major Adverse Cardiovascular and Cerebrovascular Events in Hospitalized Cancer Patients with Hypertensive Crisis: A Nationwide Population-Based Study

Background: Cancer patients have an increased risk of new-onset hypertension. Burden, comorbidities, and outcomes of hypertensive crisis (HTNcrisis) in prior and current cancer patients remain undefined. Methods: The National Inpatient Sample (2015 October-2017) was used to identify cancer patients (current+prior cancer) and sub-grouped into HTNcrisis vs. non-HTNcrisis to compare demographics, comorbidities, and outcomes (MACCE-major adverse cardiovascular and cerebrovascular events: all-cause mortality, acute myocardial infarction, cardiac arrest &amp; stroke). Results: Active or prior cancer diagnosis had 9,279,536 admissions, of which 70,530 had HTNcrisis (0.8%). HTNcrisis arm more often included older (74 vs. 71 years), black (22.5 vs. 11.0%), female (58.5% vs. 50.7%), Medicare enrollees (77.2% vs. 67.9%) vs. non-HTNcrisis (Table 1) . HTNcrisis arm had higher rates of hyperlipidemia, smoking, diabetes, renal failure, CHF, prior TIA/stroke, prior CABG vs non-HTNcrisis. Cancer with HTNcrisis had higher rate and odds of MACCE (9.7% vs.19.6%, OR:1.92, 95CI:1.88-1.96), higher rate of AMI (7.6% vs 3.3%), arrhythmia (29.8% vs 27.2%), stroke (10.8% vs 3.0%) with comparable healthcare resource utilization (p&lt;0.001). Of the HTNcrisis cohort, patients with an active cancer diagnosis with prior history of treated cancer (4.9%) had higher all-cause mortality compared to patients with either currently active cancer (4.0%) or prior cancer (2.1%) (p&lt;0.001). Conclusion: Cancer patients with HTNcrisis often included elderly, black, and female compared to those without. HTNcrisis admissions had two times higher odds of MACCE including higher rates of AMI, arrhythmia and stroke. Among HTNcrisis admissions, patients currently diagnosed with active cancer along with prior history experienced a higher burden of inpatient deaths compared to admissions either with current or prior cancer.

Effect of fasting blood glucose on risk of new\u2010onset hypertension in rural Chinese population: a 15-year follow-up cohort

BackgroundThe purpose of this study was to examine the correlation between fasting blood glucose and new-onset hypertension and examine any synergistically effect modification with multiple risk factors.MethodsWe conducted post-hoc analyses of repeated-measures data in the original Dongzhi osteoporosis cohort study. In total, 3985 participants without hypertension aged 25–64 years were included in the current analyses. Generalized estimating equation models were used to assess the relationship between fasting blood glucose and risk of new-onset hypertension after adjusting for pertinent covariates and autocorrelations among siblings.Results393 men (19.4%) and 398 women (20.3%) without hypertension at the baseline developed hypertension by the end of the study period. Compared to lower baseline fasting blood glucose levels (Q1–Q3: < 5.74 mmol/L; clinical cut points: < 5.6 mmol/L), higher baseline fasting blood glucose levels (Q4: ≥ 5.74 mmol/L; clinical cut points: ≥ 5.6 mmol/L and < 7.0 mmol/L) increased the risk of new-onset hypertension significantly [(OR: 1.54, 95% CI 1.19–1.98, P < 0.001); (OR: 1.38, 95% CI 1.09–1.75, P = 0.008)] in women. Additionally, a stronger significant association was found in women with elevated fasting blood glucose on risk of new-onset of hypertension with higher total cholesterol (≥ 5.2 mmol/L) [(OR: 2.76; 95% CI: (1.54, 4.96), P < 0.001)]. However, no association was found between fasting blood glucose and risk of new-onset hypertension in men.ConclusionsHigh fasting blood glucose may be significantly associated with risk of new-onset hypertension in Chinese women, especially in women with higher total cholesterol. Further randomized studies are needed to confirm our findings.

Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population.

BACKGROUNDArterial stiffness, as assessed by aortic ultrasound and pulse wave velocity, is associated with incident hypertension. However, there is still no consensus on whether the augmentation index (AI) affects new onset of hypertension. This study investigated the relationship of radial AI (rAI) and incident hypertension in a Chinese community-based population without hypertension at baseline.METHODA total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing, China were included in our analysis. Baseline rAI normalized to heart rate of 75 beats/min (rAIp75) was obtained using HEM-9000AI. New-onset hypertension was defined as blood pressure ≥ 140/90 mmHg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey. Multivariate regression models were used to evaluate the impact of rAIp75 on the risk of new-onset hypertension.RESULTSAfter a mean 2.35-year follow-up, 213 (13.19%) participants developed incident hypertension. No significant relation between rAIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders (adjusted odds ratio (OR) and 95% confidence interval (CI): 1.09 [0.95−1.27];P = 0.2260). However, rAIp75 was significantly associated with incident hypertension in women, but not in men (adjusted OR and 95% CI: 1.29 [1.06−1.56],P = 0.0113 for women; 0.91 [0.72−1.15],P = 0.4244 for men; P for interaction = 0.0133). CONCLUSIONSSex modified the effect of the rAI on incident hypertension in a Chinese, community-based, non-hypertensive population. Screening of the rAI could be considered in women with a high risk of hypertension for the purpose of primary intervention.