Adiposity indices and their higher predictive value for new-onset hypertension in metabolically healthy young women: findings from a population-based prospective cohort study

BACKGROUND AND AIMS

The present study aimed to investigate the predictive ability of selected adiposity indices, such as body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and waist-to-height ratio (WHtR), for new-onset hypertension in metabolically healthy Taiwanese adults. The study also sought to establish sex-specific cutoff points for these indices and to analyze the risk of new-onset hypertension, taking into account sex and age.

METHODS

This prospective cohort study utilized the Taiwan Biobank database to examine metabolically healthy participants aged between 20 and 65 at baseline. Four adiposity indices, namely BMI, WHR, WC, and WHtR, were calculated and used to predict new-onset hypertension over 4 years. Receiver operating characteristics (ROCs) and areas under the curve (AUCs) were used to evaluate the effectiveness of the parameters in predicting new-onset hypertension over 4 years. Sex-specific cutoff points were identified and used to assess the risk of new-onset hypertension.

RESULTS

This study analyzed 13,375 participants over 4.28 years. The incidence of new-onset hypertension was 17.65%. The new-onset rate of hypertension was 34.39% in men and 65.61% in women. Adiposity indices effectively predict new-onset hypertension, with WHtR having the highest predictive value (i.e., AUC) for both sexes. The classification of participants into low and high categories for each adiposity index was based on sex-specific cutoff points, and the risk of new-onset hypertension was assessed according to sex and age. This study found that high adiposity indices predicted a significantly higher risk of new-onset hypertension in metabolically healthy adults. The risk was equal for both sexes. Young women had a higher risk of new-onset hypertension than middle-aged women when they were further categorized. All risk ratios of the indices in young women were over two-fold and significant.

CONCLUSION

According to the sex-specific cutoff point, high adiposity indices had a higher predictive value for new-onset hypertension in metabolically healthy Taiwanese young women.

Positive association between dietary manganese intake and new-onset hypertension: A nationwide cohort study in China

BACKGROUND AND AIM

To date, few studies have investigated the association between dietary manganese intake and the risk of hypertension, so the prospective relationship of dietary manganese intake and new-onset hypertension remains uncertain. We aimed to investigate the association between dietary manganese intake and the risk of new-onset hypertension in the general Chinese population.

METHODS AND RESULTS

This prospective cohort study included 12,177 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by a physician or under antihypertensive treatment during the follow-up. During a median follow-up duration of 6.1 years, 4269 (44.9 per 1000 person-years) participants developed new-onset hypertension. Overall, there was a positive association between dietary manganese intake and new-onset hypertension. The adjusted HRs (95%CIs) of new-onset hypertension were 1.00 (reference), 0.97 (0.87, 1.08), 1.24 (1.10, 1.39) and 1.75 (1.52, 2.01) across the quartiles of dietary manganese intake, respectively. Accordingly, a significantly higher risk of new-onset hypertension (HR, 1.38; 95%CI: 1.27, 1.50) was found in participants in quartiles 3-4 of dietary manganese intake (≥6.0 mg/day), compared with those in quartiles 1-2 (<6.0 mg/day).

CONCLUSIONS

In the general Chinese population, dietary manganese intake was positively associated with the risk of new hypertension, independent of sodium intake and other important covariates.

Mobile phone calls, genetic susceptibility, and new-onset hypertension: results from 212 046 UK Biobank participants

Aims

The relationship between mobile phone use for making or receiving calls and hypertension risk remains uncertain. We aimed to examine the associations of mobile phone use for making or receiving calls and the use frequency with new-onset hypertension in the general population, using data from the UK Biobank.

Methods and results

A total of 212 046 participants without prior hypertension in the UK Biobank were included. Participants who have been using a mobile phone at least once per week to make or receive calls were defined as mobile phone users. The primary outcome was new-onset hypertension. During a median follow-up of 12.0 years, 13 984 participants developed new-onset hypertension. Compared with mobile phone non-users, a significantly higher risk of new-onset hypertension was found in mobile phone users [hazards ratio (HR), 1.07; 95% confidence interval (CI): 1.01-1.12]. Among mobile phone users, compared with those with a weekly usage time of mobile phones for making or receiving calls <5 mins, significantly higher risks of new-onset hypertension were found in participants with a weekly usage time of 30-59 mins (HR, 1.08; 95%CI: 1.01-1.16), 1-3 h (HR, 1.13; 95%CI: 1.06-1.22), 4-6 h (HR, 1.16; 95%CI: 1.04-1.29), and >6 h (HR, 1.25; 95%CI: 1.13-1.39) (P for trend <0.001). Moreover, participants with both high genetic risks of hypertension and longer weekly usage time of mobile phones making or receiving calls had the highest risk of new-onset hypertension.

Conclusions

Mobile phone use for making or receiving calls was significantly associated with a higher risk of new-onset hypertension, especially among high-frequency users.

Positive association of triglyceride-glucose index with new-onset hypertension among adults: a national cohort study in China

BACKGROUND

Previous studies showed that the triglyceride-glucose (TyG) index was a better predictor of adverse cardiovascular events than triglycerides or fasting blood glucose alone. However, few studies have focused on new-onset hypertension. We aimed to explore the association of TyG index with new-onset hypertension in Chinese adults.

METHODS

A total of 4,600 participants who underwent at least 2 rounds of visits from 2009 to 2015 in the China Health and Nutrition Survey were enrolled in this study. Our outcome of interest was new-onset hypertension. Multivariate Cox hazard regression models and restricted cubic spline were performed to explore the relationship between TyG index and new-onset hypertension.

RESULTS

The mean (standard deviation, SD) age of the study population was 48.1 (13.6) years, and 2058 (44.7%) of the participants were men. The mean (SD) TyG index level was 8.6 (0.7). A total of 1,211 (26.3%) participants developed new-onset hypertension during a median (interquartile range) follow-up duration of 6.0 (2.0-6.1) years. The incidences of new-onset hypertension were 18.1%, 25.3%, 28.5%, and 33.4% by quartiles of TyG index [from quartile 1 (Q1) to Q4], respectively. The Cox model showed that high levels of TyG index were significantly associated with increased risk of new-onset hypertension (adjusted hazard ratio [aHR]: 1.29, 95% confidence interval [CI] 1.07-1.55, Q2; aHR, 1.24, 95% CI 1.03-1.49, Q3; aHR, 1.50, 95% CI 1.22-1.84, Q4) compared with Q1. Consistently, as a continuous variable, for every 1.0 increase in TyG index, there was a 17% increase in the risk of new-onset hypertension (aHR, 1.17; 95% CI 1.04-1.31). The associations were consistent in various subgroups and sensitivity analysis. The dose-response curve indicated a positive, linear association between TyG index and the risk of new-onset hypertension.

CONCLUSIONS

High TyG index was significantly associated with an increased risk of new-onset hypertension among Chinese adults. Our findings suggest that maintaining a relatively low level of TyG index might be effective in the primary prevention of hypertension.

Variety and quantity of dietary insoluble fiber intake from different sources and risk of new-onset hypertension

BACKGROUND

The relations of the variety and quantity of different sources of dietary insoluble fibers and hypertension remain uncertain. We aimed to investigate the associations between the variety and quantity of insoluble fibers intake from six major food sources and new-onset hypertension, using data from the China Health and Nutrition Survey (CHNS).

METHODS

Twelve thousand one hundred thirty-one participants without hypertension at baseline from CHNS were included. Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. The variety score of insoluble fiber sources was defined as the number of insoluble fiber sources consumed at the appropriate level, accounting for both types and quantities of insoluble fibers. The study outcome was new-onset hypertension, defined as blood pressure ≥ 140/90 mmHg, or physician-diagnosed hypertension or receiving antihypertensive treatments during the follow-up.

RESULTS

During a median follow-up of 6.1 years, 4252 participants developed hypertension. There were L-shaped associations of dietary insoluble fibers derived from vegetables, beans, tubers, and fruits with new-onset hypertension; a reversed J-shaped association of whole grain-derived insoluble fiber with new-onset hypertension; and no obvious association of refined grain-derived insoluble fiber with new-onset hypertension. Therefore, refined grain was not included in the insoluble fiber variety score calculation. More importantly, a higher insoluble fiber variety score was significantly associated with lower risks of new-onset hypertension (per score increment, hazard ratio, 0.50; 95% CI, 0.45-0.55).

CONCLUSIONS

There was an inverse association between the variety of insoluble fibers with appropriate quantity from different food sources and new-onset hypertension.

Domestic Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China

BACKGROUND

The relation of domestic physical activity with hypertension remains uncertain. We aimed to evaluate the prospective relation of domestic physical activity and new-onset hypertension among Chinese males and females.

METHODS

A total of 9254 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey. Data on domestic physical activity were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-hours/week. Metabolic equivalent task-hours/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up.

RESULTS

A total of 2892 participants developed hypertension during 81996 person-years of follow-up. Overall, there were reversed J-shaped associations between the domestic physical activity and new-onset hypertension in both males and females (both P values for nonlinearity < .001). Consistently, when domestic physical activity was assessed as categories (<10, 10 -< 20, 20 -< 30, 30 -< 40, 40 -< 50, 50 -< 60, 60 -<70, 70 -< 80, 80 -< 90, 90 -< 100, ≥100 MET-hours/week), compared with those with domestic physical activity < 10 MET-hours/week, the lower and similar risks of new-onset hypertension were found in participants with domestic physical activity 30 -< 90 MET-hours/week in both males and females.

CONCLUSIONS

Moderate domestic physical activity was associated with a lower risk of new-onset hypertension among both males and females.

Transportation physical activity and new-onset hypertension: A nationwide cohort study in China

The association between transportation physical activity (PA) and the risk of hypertension remains uncertain. We aimed to evaluated the prospective relation of transportation PA and new-onset hypertension among Chinese adults. A total of 9350 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey (CHNS). Data on transportation PA were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-minutes/week. MET-minutes/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 8.0 years (82,410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a U-shaped association between transportation PA and new-onset hypertension (P values for nonlinearity <0.001). Accordingly, compared with those with moderate transportation PA (213-<394 MET-minutes/week, the second quartile), significantly higher risks of new-onset hypertension were observed not only in participants with transportation PA < 213 MET-minutes/week (the first quartile) (HR, 1.29; 95%CI: 1.15-1.44), but in those with transportation PA ≥ 394 MET-minutes/ week (the 3-4 quartiles) (HR, 1.15; 95%CI: 1.04-1.27). Similar U-shaped correlations were found for various types of transportation PA (walking, bicycling, and motorized PA) and new-onset hypertension. In summary, moderate transportation PA is associated with a lower risk of new-onset hypertension among Chinese adults.

U-shaped association between dietary copper intake and new-onset hypertension

AIMS

To investigate the relationship of dietary copper intake with new-onset hypertension among Chinese adults.

METHODS

A total of 12,245 participants who were free of hypertension at baseline from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. New-onset hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up.

RESULTS

During a median follow-up of 6.1 years, 4304 participants developed new-onset hypertension. Overall, the associations between dietary copper intake and new-onset hypertension followed a U-shape (P for nonlinearity <0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary copper intake (per SD increment: HR, 0.71; 95% CI, 0.57-0.88) in participants with copper intake <1.57 mg/day, and increased with the increment of dietary copper intake (per SD increment: HR, 1.09; 95% CI: 1.07-1.12) in participants with copper intake ≥1.57 mg/day.

CONCLUSIONS

There was a U-shaped association between dietary copper intake and new-onset hypertension in general Chinese adults, with an inflection point at about 1.57 mg/day. Our results emphasized the importance of maintaining optimal copper intake levels for the primary prevention of hypertension.