While several modifiable risk factors have been identified, the proportion of patients with new-onset hypertension that could conceivably be prevented by modification of a combination of lifestyle factors has not previously been evaluated.
Lead researcher Dr John P. Forman, of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues examined the association between combinations of low-risk lifestyle factors and the risk of developing hypertension.
They looked at 83,882 adult women (age 27 to 44 years) in the second Nurses' Health Study who did not have hypertension, cardiovascular disease, diabetes, or cancer in 1991, and who had normal reported blood pressure and identified six modifiable lifestyle and dietary factors.
These included a body mass index (BMI) of less than 25; a daily average of 30 minutes of vigorous exercise, a high score on the Dietary Approaches to Stop Hypertension (DASH) diet based on responses to a food frequency questionnaire, modest alcohol intake, use of nonnarcotic analgesics less than once per week and intake of 400 ug/d or more of supplemental folic acid.
A DASH score was determined based on high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats.
The association between combinations of 3 (normal BMI, daily vigorous exercise, and DASH-style diet), 4 (3 low-risk factors plus modest alcohol intake), 5 (4 low-risk factors plus avoidance of nonnarcotic analgesics), and 6 (folic acid supplementation) low-risk factors and the risk of developing hypertension was analyzed.
For women who had all 6 low-risk factors they had about an 80 percent lower risk of developing high blood pressure.
"Data indicate that adherence to a combination of low-risk lifestyle factors could have the potential to prevent the majority of new-onset hypertension in young women irrespective of family history of hypertension and irrespective of oral contraceptive use," wrote the authors.
"In conclusion, adherence to low-risk dietary and lifestyle factors was associated with significant reductions in the incidence of self-reported hypertension and could have the potential to prevent a large proportion of new-onset hypertension occurring among young women," they added.