Incidence of hypertension in an urban population - can we modify the risk?

Abstract

INTRODUCTION AND AIMS: To determine the incidence and risk factors of incident hypertension in an urban population in Sri Lanka. METHODS: This study was conducted in the Ragama Health Study Cohort which consists of 2986 individuals between 35-64 years of age living in the Ragama Medical Officer of Health area in the district of Gampaha. Participants were selected using age-stratified random sampling from the electoral lists in 2007 arid investigated using clinical, bio-chemical and anthropometric examinations and liver ultrasound for assessment of fatty liver. A complete follow-up assessment of the cohort was conducted in 2010. Baseline age-adjusted prevalence and three year incidence of hypertension was estimated. Independent predictors of incident hypertension were identified by Cox's Proportional Hazards modelling. Results: Baseline age-adjusted prevalence of hypertension was 33% in males and 37% in females. Out of 1644 normotensive subjects at baseline, 407 [24.8) developed hypertension by 2010. Incidence was 80.2 per 1000 person-years of follow up. Overall incidence was higher in females. Highest incidence (111 per 1000 person-years of follow up] was seen in males in the oldest age group (55-64 years). Independent predictors of incident hypertension were low level of physical activity, presence of diabetes mellitus, a BMI over 25 kg/m2, presence of non-alcoholic fatty liver disease and older age. CONCLUSIONS: Risk of incident hypertension is largely modifiable as evident from the findings from this population with a high incidence of hypertension highlighting the need for lifestyle modifications targeting physical activity and diet at both population and individual level for prevention of hypertension.