Comparison of High-Risk Lifestyles and Obesity in Predicting Risk of Incident Hypertension: A Cohort Study

Abstract Background The aim of this study was to compare the impact of obesity and lifestyle factors, including sedentary behavior, high fat diet and low fiber diet on incident essential hypertension (EH) in a population-based Chinese cohort. Methods We analyzed data from a population-based prospective cohort of 2778 participants aged 35–74 years from Jiangsu China who were free of hypertension, diabetes and cardiovascular disease (CVD) at enrollment and were followed for hypertension events. Results Cox proportional hazards regression model was used to calculate the hazard ratio (HR) of hypertension and corresponding 95% confidence interval (CI). A total of 2778 participants were studied, including 660 cases. In non-obese subjects, SBP and DBP levels were lower in subjects without high risk lifestyles, compared to subjects with high risk lifestyles. However, in obese subjects, SBP and DBP levels were not different between subjects with and without high-risk lifestyles. In non-obese subjects, all high risk lifestyles were associated with higher EH risk, however, all high risk lifestyles were not associated with EH in obese subjects. Conclusions Obesity was a more important risk factor of EH than high-risk lifestyles. Life style modification may achieve few effects on EH risk if no weight was lost. Life style modification only achieved few effects on EH risk factors in obese subjects, suggesting that a focus on reducing obesity through a broad range of actions is likely to be more effective in preventing EH than an approach that solely focuses on inactivity and unhealthy diet style.