Changes in Cardiovascular Health Status and the Risk of New-Onset Hypertension in Kailuan Cohort Study

Abstract

American Heart Association cardiovascular health metrics are intimately related to cardiovascular diseases. Acting as a key independent risk factor for high morbidity and mortality of cardiovascular diseases, hypertension and its relationship between health status get urgent attention. While the influence of individual health status changes and the future risk of new-onset hypertension is rarely understood, the present study applied this construct to assess the changes of cardiovascular health status and the morbidity of hypertension in Kailuan cohort study in north China. The Cardiovascular Health Score (CHS) was evaluated by the follow-ups of 2006-2007, 2008-2009, 2010-2011 and 2012-2013. The study population (n = 19381) was divided into 5 groups based on the changes in their CHS score between the first two follow-ups (△CHS) of 2006-2007 and 2008-2009 (≤-2, -1, 0, 1, ≥2). The morbidity of hypertension was collected during 2010-2011 and 2012-2013 follow-ups. Data analysis showed that during a median follow-up of 3.79±0.96 years, morbidity of hypertension had a graded relationship with △CHS. As △CHS scored from low to high, the standardized morbidity of hypertension for all participants were 81.40, 75.47, 68.37, 71.43 and 83.13 per 1000 person-year, respectively. An increased △CHS score of 1 was associated with a 10% decrease in the future risk of new-onset hypertension(HR: 0.90, 95% CI: 0.88-0.92). In conclusion, there was a strong inverse relationship between the incidence of new-onset hypertension and elevation of cardiovascular health metrics. Population-wide prevention, especially the promotion of lifestyle improvements, is critical to reducing the morbidity of new-onset hypertension.

Fig 1. Selection of Kailuan study participants for analysis.