Sex differences in hypertension incidence and risk factors: a population-based cohort study in Southern Iran

• Published in: BMC public health Vol. 24; no. 1; pp. 3575 - 16
• Main Authors: Rezaianzadeh, Abbas, Johari, Masoumeh Ghoddusi, Baeradeh, Najibullah, Seif, Mozhgan, Hosseini, Seyed Vahid
• Format: Journal Article
• Language: English
• Published: London BioMed Central 23.12.2024; BioMed Central Ltd; BMC
• Subjects: Adult; Age; Aged; Alcohol; Biostatistics; Blood pressure; Calculi; Care and treatment; Chronic illnesses; Cohort analysis; Cohort Studies; Cohort study; Contraceptives; Diabetes; Diagnosis; Disease; Environmental Health; Epidemiology; Exercise; Family medical history; Female; Females; Gender; Gender aspects; Gender differences; Humans; Hypertension; Hypertension - epidemiology; Incidence; Iran - epidemiology; Kidneys; Lifestyles; Male; Marital status; Medicine; Medicine & Public Health; Men; Middle Aged; Mortality; Nephrolithiasis; Population; Population studies; Prevention; Proportional Hazards Models; Prospective Studies; Public Health; Regression analysis; Regression models; Risk Factors; Sex; Sex differences; Sex Factors; Smoking; Socioeconomic factors; Socioeconomic status; Statins; Strategic management; Stroke; Vaccine; Women; Womens health; Iran; Hypertension; Cohort study; Risk factors; Sex; Incidence
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-21082-8

Background Hypertension (HTN) is a major global public health concern. This study aims to identify gender differences to inform more effective prevention strategies and targeted management approaches. Methods This prospective cohort study included 7,710 participants aged 40 to 70 years, with a mean follow-up duration of 5.2 years. HTN was defined using European hypertension management guidelines. A Cox regression model was employed to determine factors associated with HTN, adjusting for confounding variables effects. Results During the mean follow-up period of 5.2 years, the incidence rate of hypertension was 21.54 per 1,000 person-years, with females exhibiting a higher incidence than males. Several significant predictors of HTN were identified. In men, key risk factors included age (60–70 years, 2.83-fold increase, 95% CI 2.05–3.92), high waist-to-height ratio (5.63-fold increase, 95% CI 2.42–13.07), smoking (2.68-fold increase, 95% CI 1.04–6.91), and opium use (1.93-fold increase, 95% CI 1.06–3.49). In women, significant predictors included age (60–70 years, 3.65-fold increase, 95% CI 2.59–5.15), contraceptive drug use (1.24-fold increase, 95% CI 1.01–1.52), high waist-to-height ratio (1.87-fold increase, 95% CI 1.19–2.92), pre-HTN (3.64-fold increase, 95% CI 3.01–4.40), and kidney stones (1.32-fold increase, 95% CI 1.06–1.65). Conclusion This study identified key predictors of hypertension (HTN) with notable gender differences. For men, significant risk factors included age, high waist-to-height ratio, smoking, and opium use; for women, the prominent predictors were age, contraceptive use, pre-HTN, and kidney stones. These findings highlight the need for gender-specific strategies in HTN prevention and management, focusing on modifiable risk factors by gender.