Multiple risk factor clustering of hypertension in a screened cohort

Objective A family history of hypertension, obesity, diabetes mellitus, hyp ercholesterolaemia and hypertriglyceridaemia have all been associated with the risk for hypertension. We evaluated whether the clustering of these ris k factors increases the risk for hypertension or whether the accumulation o f risk factors is associated with the blood pressure level in non-hypertens ive subjects. Methods and subjects We assessed the clinical data and family history of hy pertension (in parents end siblings) for 9914 individuals (6163 men and 375 1 women, 18-89 years old) who were screened in Okinawa, Japan, in 1997. Results In 9914 subjects (2465 hypertensive and 7449 non-hypertensive subje cts), all the five factors were positively associated with hypertension. Th e odds ratios (95% confidence interval) for the number of risk factors were 1.88 (1.62-2.18) for one risk factor, 3.06 (2.62-3.57) for two, 5.25 (4.37 -6.30) for three, 8.71 (6.48-11.72) for four and 24.48 (8.49-70.56) for fiv e, after adjusting for age, se? alcohol consumption, cigarette smoking and physical exercise habits. In non-hypertensive subjects, multivariate regres sion analyses showed that the number of risks was positively correlated wit h blood pressure; the regression coefficient was 1.96 (P < 0.0001) for syst olic blood pressure, and 1.47 (P < 0.0001) for diastolic blood pressure aft er adjusting for age and sex. Conclusions Clustering of risk factors was significantly associated with hy pertension. The number of risk factors positively correlated with the blood pressure levels in non-hypertensive subjects. The accumulation of risk fac tors may play an important role in the pathogenesis of hypertension, and th us the aggregation of risk factors may need to be addressed in primary prev ention efforts related to hypertension. J Hypertens 18:1379-1385 (C) 2000 L ippincott Williams & Wilkins.