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Int J Med Sci 2015; 12(7):605-612. doi:10.7150/ijms.12446

Research Paper

Lifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive Cohort

Yao Lu1, Minggen Lu2, Haijiang Dai1, Pinting Yang3, Julie Smith-Gagen2, Rujia Miao1, Hua Zhong1, Ruifang Chen1, Xing Liu1, Zhijun Huang1*, Hong Yuan1*✉

1. Center of Clinical Pharmacology, the Third Xiangya Hospital, Central South University, Changsha, China
2. School of Community Health Sciences, University of Nevada, Reno, NV, USA
3. Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China
*Zhijun Huang and Hong Yuan share senior authorship.


Objectives: To determine whether healthy lifestyle decreases the risk of developing hypertension in pre-hypertensive patients.

Study design: A longitudinal study.

Setting & participants: Randomly selected pre-hypertensive young adults 20-45 years old without any vascular disease such as stroke or diabetes.

Predictors: Four lifestyle factors (a body mass index [BMI] of 18.5-24.9 kg/m2, regular physical activity, no alcohol use and 6-8 h of sleep per day), individually and in combination.

Outcomes: Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mmHg, or a diastolic BP (DBP) ≥ 90 mmHg or self-reported hypertension.

Measurements: Multivariate adjusted Cox proportional hazards.

Results: During a median follow-up of 4.7 years, 1009 patients were enrolled in our study, and 182 patients developed hypertension. Compared with a BMI of 18.5-24.9 kg/m2, a BMI of 25-30 kg/m2 and a BMI of >30 kg/m2 were associated with an increased risk of hypertension occurrence (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.19-2.84 and HR, 2.62; 95% CI, 1.01-6.80, respectively). Compared with sleep duration of >8 h/day, 6-8 h/day of sleep was associated with a lower risk of hypertension occurrence (HR, 0.40; 95% CI, 0.18-0.86). There were no statistically significant associations between physical activity or alcohol use and hypertension occurrence (P>0.05).

Limitation: All lifestyle factors were measured only once.

Conclusion: Healthy BMI (18.5-24.9 kg/m2) and sleep duration (6-8 h/day) were associated with a lower risk of the occurrence of hypertension in pre-hypertension patients.

Keywords: Pre-hypertension, BMI, Alcohol, Physical activity, Sleep duration, Hypertension

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Lu Y, Lu M, Dai H, Yang P, Smith-Gagen J, Miao R, Zhong H, Chen R, Liu X, Huang Z, Yuan H. Lifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive Cohort. Int J Med Sci 2015; 12(7):605-612. doi:10.7150/ijms.12446. Available from