Published online before print January 23, 2006, doi: 10.1161/01.HYP.0000200710.29498.80
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(Hypertension. 2006;47:403.)
© 2006 American Heart Association, Inc.
Original Articles |
A Longitudinal Study of Hypertension Risk Factors and Their Relation to Cardiovascular Disease
The Strong Heart Study
From the Center for American Indian Health Research (W.W., E.T.L.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City; Epidemiology and Biometry Program (R.R.F.), National Heart, Lung, and Blood Institute, Bethesda, Md; Cornell University Medical Center (R.D.), New York, NY; Missouri Breaks Industries Research, Inc. (L.B.), Timber Lake, SD; Aberdeen Area Tribal Chairmen’s Health Board (T.K.W.), Rapid City, SD; and MedStar Research Institute (B.V.H.), Washington, DC.
Correspondence to Wenyu Wang, Center for American Indian Health Research, College of Public Health, University of Oklahoma HSC, PO Box 26901, Oklahoma City, OK 73190. E-mail wenyu-wang{at}ouhsc.edu
This study estimated hypertension incidence and explored hypertension risk factors and their association with cardiovascular disease. Data collected from 4549 American Indian participants in the 3 exams of the Strong Heart Study were used. Hypertension was defined as systolic blood pressure 
140 mm Hg, diastolic blood pressure 90 mm Hg, or current use of antihypertensive medication. Generalized linear models were used to identify the risk factors for hypertension and the correlates of blood pressures. Cox proportional models with time-dependent covariates and the mixed models were used to explore the association of hypertension with cardiovascular disease. There was no sex difference in hypertension. After adjustment for other risk factors, the risks of developing hypertension among subgroups in each characterized group were as follows: prehypertensive versus normotensive, 3.21 times; macroalbuminuria and microalbuminuria versus normal, 3.47 and 1.72; diabetic versus nondiabetic, 1.56; overweight and obese versus normal weight, 1.30 and 1.51; and current alcohol drinking versus not, 1.22. Moreover, systolic blood pressure was significantly and positively associated with age, obesity, and albuminuria and negatively with smoking. After adjusting all other risk factors, those pretreated, untreated, controlled, and uncontrolled hypertensive participants had &1.74, 1.81, 2.19, and 2.77 times higher risks of developing cardiovascular disease compared with normotensive participants, respectively. In 45- to 74-year-old American Indians, the risk of developing hypertension was rising. Prehypertensive participants had 3.2/1.74 times higher risk of developing hypertension/cardiovascular disease than normotensive participants. Age, diabetes, and macro/microalbuminuria were independently significant risk factors of both hypertension and cardiovascular disease.
Key Words: risk factors • cardiovascular diseases
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