Association between lifestyle risk factors and incident hypertension among middle-aged and older Australians

This study aimed to examine the association between individual and combined lifestyle risk factors and the incidence of hypertension 1) in middle-aged and older Australians, and 2) to compare findings in men and women. A sample of 32,393 adults aged >= 45 years from New South Wales completed baseline (2006-2008) and follow-up (2010) questionnaires. Self-reported incident hypertension was defined as not having physician-diagnosed hypertension nor taking antihypertensive medications at baseline and reporting a diagnosis/treatment of hypertension at follow-up. High-risk categories for six lifestyle risk factors were defined as: a BMI >= 25 kg/m(2), physical activity levels < 150 min/week, consuming >= 14 alcohol drinks/week, being a current smoker, consuming < 2 fruit and/or < 3 vegetable serves/day, and being at high risk of psychological distress (Kessler-10 score >= 22). The association between baseline risk factors and incident hypertension was examined using logistic regression models, adjusted for socio-demographic, medical and lifestyle risk factors. After 2.7 (SD: 0.9) years of follow-up, 17.1% developed hypertension. Compared to low-risk categories, high BMI (AOR [95% CI]: 1.99 [1.85, 2.13]), high alcohol intake (1.58 [1.44, 1.73]), low physical activity levels (1.17 [1.07, 1.27]) and being a current smoker (1.15 [1.0, 1.31]) were associated with a higher incidence of hypertension in the overall sample, with similar associations in men and women. The number of high-risk lifestyle factors was positively associated with higher odds of developing hypertension in the overall sample, men and women; with a stronger association in middle-aged men. Adopting a low-risk lifestyle may prevent hypertension among middle-aged and older adults.