Associations between cardiovascular health metrics in life’s essential 8 and incident hypertension: The LIFE Study

The American Heart Association’s Life’s Essential 8 is a set of modifiable lifestyle habits and risk factors used to assess cardiovascular health (CVH). However, little is known about the potential impact of non-ideal statuses in these metrics on hypertension risk. This study aimed to clarify the associations between the total number of non-ideal CVH metrics and incident hypertension in a Japanese population. This retrospective cohort study was conducted using data from 10 Japanese municipalities participating in the LIFE Study. We identified National Health Insurance enrollees who had undergone health checkups between April 2017 and March 2018. Participants were categorized into 7 groups (0, 1, 2, 3, 4, 5, and 6–7 metrics) based on their total number of non-ideal CVH metrics (excluding blood pressure). The hazard ratio of each group (reference: 0 metrics) for new-onset hypertension was estimated using Cox proportional hazards models. During a mean follow-up period of 1405 days, 22 826 (24.5%) participants developed hypertension. Hypertension risk significantly increased with higher numbers of non-ideal CVH metrics (hazard ratios ranged from 1.067 for 1 metric to 1.609 for 6–7 metrics). Additionally, all non-ideal CVH metrics except for blood lipids were found to be significant predictors of hypertension. Higher numbers of non-ideal CVH metrics in Life’s Essential 8 were consistently associated with a higher incidence of hypertension. Multicomponent lifestyle modification strategies that improve overall CVH status may help to prevent hypertension.