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The association of ideal cardiovascular health metrics and incident hypertension among an urban population of Iran: a decade follow-up in Tehran Lipid and Glucose Study

Journal of Human Hypertension volume 38, pages 267–276 (2024)Cite this article

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Abstract

We aimed to determine the association between ideal cardiovascular health metrics (ICVHM) and the incidence of hypertension among Iranian adults. The study population included 5409 Iranian adults aged ≥20 years (2088 men) without hypertension (applying the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline) at baseline. The ICVHM was defined according to the AHA’s 2020 impact goals, excluding total cholesterol was replaced by non-HDL cholesterol (non-HDL-C). Multivariable Cox proportional hazards regression analysis was done to estimate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. During a median 8.5-year follow-up, 2972 new cases of hypertension were identified (men: 1,287). Non-HDL-C < 130 mg/dL in men [HR (95% CI): 0.75(0.65–0.86)] and fasting plasma glucose(FPG) < 100 mg/dL in women[HR (95% CI): 0.79(0.64–0.97)], and among both genders, being normal/overweigth status (compared to obese) and blood pressure <120/80 mmHg were associated with a lower risk for hypertension. Additionally, in both gender, a 1-point increase in the number of global ICVHM decreased the risk of hypertension by more than 10%, and having ≥5 vs. <2 ICVHM, were associated with a lower risk of hypertension by 30% (all p values < 0.05). Applying the JNC 7 guideline, the association between ICVHM, with incident hypertension, were generally similar. Having a higher number of ICVHM was associated with a lower risk of incident hypertension, using both 2017 ACC/AHA and JNC 7 guidelines, mostly attributable to keeping the ideal status of body mass index, non-HDL-C, and FPG.

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Fig. 1: The Multivariable association between categories of ideal cardiovascular health metric (poor, intermediate, and ideal) and incident hypertension according to 2017 ACC/AHA for men and women separately.

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The data and code underlying this article will be shared on reasonable request to the corresponding author.

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Author notes

  1. These authors contributed equally: Fatemeh Rahmani, Samaneh Asgari.

Authors and Affiliations

  1. Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fatemeh Rahmani

  2. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fatemeh Rahmani, Samaneh Asgari & Farzad Hadaegh

  3. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fereidoun Azizi

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  1. Fatemeh Rahmani
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  2. Samaneh Asgari
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  3. Fereidoun Azizi
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  4. Farzad Hadaegh
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Contributions

SA, FR, and FH conceived and planned the study. FA cooperated in data gathering. SA conducted the analyses. SA, FR, and FH developed the first draft of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Farzad Hadaegh.

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The authors declare no competing interests.

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This study was approved by the Institutional Review Board (IRB) of the Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Iran, and all participants provided written informed consent.

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Rahmani, F., Asgari, S., Azizi, F. et al. The association of ideal cardiovascular health metrics and incident hypertension among an urban population of Iran: a decade follow-up in Tehran Lipid and Glucose Study. J Hum Hypertens 38, 267–276 (2024). https://doi.org/10.1038/s41371-023-00881-3

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