Prediction of incidence of hypertension in France and associated factors: results from the CONSTANCES cohort.

Abstract

Introduction: Estimating hypertension incidence and improving screening in general population could enhance blood pressure control and decrease cardiometabolic risks. Identifying those likely to develop hypertension is essential. Our study focused on predicting onset hypertension and its incidence based on initial characteristics.

Methods: We utilized data from the French prospective CONSTANCES cohort, including volunteers assessed twice over 5 years up to 31 December 2019, who were initially free from hypertension. Hypertension was defined as having a SBP at least 140 mmHg or DBP at least 90 mmHg during the second checkup or if antihypertensive medication was prescribed. We calculated annual incidence rates among subgroups and used machine learning models to identify predictors of hypertension. The impact of changes in BMI was analyzed using logistic regression.

Results: Of the 11 112 participants (average age 47.5 ± 12 years), 1929 (17.4%) developed hypertension within an average of 5.2 years, with 383 on medication. The incidence rate was 3.4 new cases per 100 person-years, rising with age and consistently higher in men (4.3 vs. 2.8). A blood pressure (BP) threshold of 130 mmHg predicted 70% of new cases. One-point BMI reduction significantly reduced hypertension risk by 16%, regardless of initial BMI and SBP levels.

Conclusion: The study reports a notable hypertension incidence of 3.4 new cases per 100 person-years, particularly among those with SBP over 130 mmHg, highlighting the need for regular screening. Early diagnosis and control can mitigate hypertension's adverse effects, emphasizing the crucial role of preventive measures like BMI reduction.