Abstract 12545: Smoking, Alcohol Consumption and Coffee Use are Predictors of Early Cardiovascular Events in Stage 1 Hypertension
Objective: Although lifestyle factors are known contributors to cardiovascular morbidity in hypertension less is known about their association with risk of events in young-to-middle-age hypertensive subjects. The purpose of this study was to assess the predictive capacity of smoking, alcohol use, coffee consumption, and physical activity for early CV events in the HARVEST study.
Methods: This analysis included 1201 participants (men, 72.9%) from the HARVEST, a multicenter prospective cohort study of subjects aged 18-45 years, screened for stage 1 hypertension, untreated at baseline. Classes were 0, 1-5, 5-10, >10 cigarettes for smokers; 0, 〈 50g, =^50 for alcohol; 0, 1-3, >3 cups for coffee; sedentary, amateurs, athletes for physical activity. Subjects were followed at 6-month intervals for a median of 12.5 years. Events were documented from hospital records.
Results: The rate of CV events was 3.6%, 4.8%, 7.9%, and 16.5%, for smokers (p≤.001); 2.2%, 7.1%, and 11.8% for alcohol use (p≤.001); 1.3%, 5.8%, and 8.3% for coffee drinking (p=.001), and 5.5%, 3.3%, and 0.9% for physical activity (p=.028).In age-and-sex-adjusted Cox analyses, all lifestyle factors were significantly associated with CV events. In a multivariable model including age, sex, parental history of CV events, BMI, metabolic data, ambulatory 24h blood pressure, antihypertensive treatment, and BMI changes over time, smoking (p≤.001), alcohol drinking (p=.001), and coffee use (p=.04), remained independent predictors of events, whereas physical activity was no longer significant (p=.37).
Conclusions: A poor lifestyle is a strong determinant of early CV events in young-to-middle age stage 1 hypertensives. The association with risk is linear for smoking, alcohol drinking and coffee use. The association with events ceased to be significant for physical activity after adjustment for blood pressure, metabolic variables, BMI and changes in BMI during follow-up.
- © 2013 by American Heart Association, Inc.