Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension: Toranomon hospital health management center study 22

Abstract

Although a family history (FH) of hypertension is a risk factor for the development of hypertension, only a few studies have investigated in detail the impact of individual components of an FH on incident hypertension. We investigated the impact of individual components and their combinations on the presence or development of hypertension considering obesity, smoking habits, physical activity, and other metabolic parameters.Studied were 12,222 Japanese individuals without hypertension (n = 9,766) and with hypertension (n = 2,456) at the baseline examination. The presence or incidence of hypertension during 5 years after a baseline examination was assessed by the presence of systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or a self-reported history of clinician-diagnosed hypertension. In this prospective study, the odds ratio for incident hypertension was 1.39 (95% confidence interval [CI], 1.22, 1.59) for individuals with any FH of hypertension compared with those without such an FH. Individuals with an FH of hypertension in both parents and one or more grandparents had an odds ratio of 3.05 (95% CI 1.74, 5.36) for hypertension compared with those without an FH of hypertension. FH was associated with incident hypertension independently of other modifiable risk factors such as obesity, smoking, physical inactivity, hyperglycemia, hyperuricemia, and hypertriglyceridemia.A parental history of hypertension was an essential component within an FH for incident hypertension. FH of hypertension over two generations with both parents affected was the most important risk factor for incident hypertension. Although an FH is not a modifiable risk factor, modifying other risk factors could contribute to reducing the risk of hypertension even among individuals with a family history of hypertension.

Figure 1

The interactions between family history of hypertension and body mass index, smoking habits, fasting plasma glucose, hemoglobin A1c, uric acid, or triglycerides for the development of hypertension. ORs (95% CI) for incident hypertension are adjusted for age and sex. Each P value for interaction of family history and body mass index, smoking habit, physical activity, fasting plasma glucose, hemoglobin A1c, uric acid, or triglycerides were 0.394, 0.701, 0.339, 0.597, 0.945, 0.853, and 0.083, respectively. BMI = body mass index, CI = confidence interval, FH+ = individuals with any family history of hypertension, FH− = individuals without any family history of hypertension, FPG = fasting plasma glucose, HbA1c = hemoglobin A1c, OR = odds ratio, TG = triglycerides, UA = uric acid.