Health-related Quality of Life and Risk of Hypertension in the Community: A Prospective Analysis from the Western New York Health Study
Background:
Measures of quality of life and health status are strong predictors of mortality and morbidity outcomes including cardiovascular disease (CVD). However, prospective epidemiological evidence from population-based studies on the potential impact of these measures on hypertension risk is scant.
Objective:
We sought to examine the independent role of measures of quality of life and health status on the risk of incident hypertension in a community-based sample from Western New York.
Methods:
A longitudinal analysis, over 6 years of follow-up, among 946 women and men (mean age 54.3 years) from the community, who were free of hypertension, CVD, and diabetes at the baseline examination, in the Western New York Health Study (WNYHS). Baseline variables included socio-demographics, anthropometrics, blood pressure, biomarker data, major behavioural risk factors, and measures of quality of life and health status, such as the physical and mental health component summaries of the short form-36 questionnaire (SF-36). Incident hypertension was defined as blood pressure > or =140/90 or on antihypertensive medication at the follow-up visit.
Results:
The cumulative six year incidence of hypertension was 22.6% (214/942). In bivariate analyses, there were several baseline correlates of incident hypertension, including age, BMI, and baseline blood pressure levels in both sexes; whereas cigarette smoking, change in BMI, family history of hypertension, and the SF-36 physical score were all significantly associated with hypertension only among women. After multivariate adjustment, cigarette use at baseline (OR: 2.96, 1.35, 6.51), family history of hypertension (OR: 2.59, 1.52-4.42), BMI change since baseline (OR: 1.18, 1.06-1.31), and the SF-36 physical score (OR: 0.97, 0.94-0.99 for a unit change) were the only significant predictors of hypertension independent of age and baseline blood pressure levels in women.
Conclusions:
Results from this study suggest that measures of health-related quality of life may represent independent predictors of hypertension risk, at least among women, above and beyond the role of traditional risk factors, such as age, smoking, body weight, and familial predisposition.
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