Abstract
Introduction:
Hypertension risk assessment is the first step towards primary prevention of hypertension. The pooled cohort equation (PCE) provides an atherosclerotic cardiovascular disease (ASCVD) risk score. We sought to examine whether incident hypertension varied across categories of ASCVD risk as defined by the PCE
Methods:
Data from the HCHS/SOL baseline and visit 2 exam were used. Hypertension (baseline and incident) was defined as SBP >140 mm Hg and DBP >90 mm Hg. We included participants 40-74 years of age free of hypertension and ASCVD at baseline (n=3,692). Participants were classified into one of four ASCVD risk categories based on the PCE: low (<5%), borderline (5-7.5%), intermediate (7.5-to 10%) and high (>10%). Survey logistic regression models were used to determine the risk of hypertension overall, by age group and Hispanic/Latino background (Dominican, Central American, Cuban, Mexican, Puerto-Rican, South American) accounting for HCHS/SOL complex survey design.
Results::
Overall, at baseline, the mean age was 51.2 ±0.23 years, 56% female, SBP: 119.7±0.26 and DBP: 72.6±0.20, ASCVD risk scores: low (65%); borderline (14.7%), intermediate (7.5%), and high (13.5%); 29.8% developed hypertension over 5.9 (range 4.1 – 9.6) years of follow-up. Intermediate (OR=2.2, CI: 1.5-3.2) and high (OR=2.5, CI: 1.9-3.5) baseline ASCVD risk categories were associated with increased odds of incident hypertension at follow-up compared to the low risk category. Age group and Hispanic/Latino background modified the relationship between increased baseline ASCVD score and incident hypertension, with strongest associations among those aged 50-59 years old (OR=2.3, CI: 1.7, 3.2) and Hispanics/Latinos of Dominican descent (OR=4.1, CI: 2.0, 8.4).
Conclusions:
Higher ASCVD risk was associated with an increased incidence of hypertension that varied by age and Hispanic/Latino background. The PCE ASCVD risk score can help guide public health measures to prevent hypertension.