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Incidence and precursors of hypertension in young adults: The Framingham offspring study
Abstract
The occurrence of hypertension and its precursors is examined in the Framingham Offspring Study of 2,027 men and 2,267 women ages 20-49 years followed for 8 years. The age-specific prevalence of hypertension was similar at both the first (1971-1975) and the second (1979-1983) examination for both men and women. Prevalence rates were higher among men than among women, and there was a higher rate of hypertension treatment at the second exam, particularly among women, 75% of whom reported being treated for hypertension. The incidence of hypertension in participants free from hypertension at the first examination increased threefold from the second to the fifth age decades in men and eight-fold in women. Under age 40, men were twice as likely as women to develop hypertension, but after age 40, 8-year incidence rates were similar in men (14.2%) and women (12.9%). Adiposity, relative weight, heart rate, alcohol intake, hematocrit, blood sugar, serum protein, triglyceride, and phosphorous were all related to hypertension occurrence in one or both sexes, controlling for age. In multivariate analysis, adiposity (P less than 0.01), heart rate (P less than 0.01), and triglyceride (P less than 0.05) were all significant independent predictors of hypertension in men. In women, adiposity (P less than 0.001), heart rate (P less than 0.01), hematocrit (P less than 0.05), and alcohol consumption (P less than 0.05) were independent contributors. When controlling for blood pressure measured at the first examination, the best single predictor of hypertension incidence, the multivariate assessment changed very little. Adiposity stands out as a major controllable contributor to hypertension. Changes in body fat over 8 years were related to changes in both systolic and diastolic blood pressure. Markedly obese women in their fourth decade were seven times more likely to develop hypertension than were lean women of the same age. Weight control deserves a high priority in efforts to prevent hypertension in the general population.
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In the citing paper
“Epidemiology studies indicate that 65–75% of primary (essential) hypertension is due to overweight or obesity7.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [7]
In the citing paper
“Excess adiposity, especially when localized in visceral regions and around the kidneys, accounts for 65–75% of the risk of primary hypertension6,7.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [7]
In the citing paper
“Excess weight gain, especially when associated with increased visceral adiposity, is a major cause of hypertension, accounting for 65–75% of the risk for human primary (essential) hypertension.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [7]
In the citing paper
“Risk estimates from the Framingham Heart Study, for example, suggest that 78 percent of primary (essential) hypertension in men and 65% in women can be ascribed to excess weight gain7.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [7]
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Metadata
- Authors
- Garrison, R. J., Kannel, W. B., Stokes, J., & Castelli, W. P.
- Affiliations
- National Heart, Lung, and Blood Institute (US)
- Boston University (US)
- Corresponding author
- Garrison, Robert J.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 1987-03
- Volume
- 16
- Issue
- 2
- Pages
- 235-251
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2013332206
- Cited by
- 789
- References
- 49
- Citations by year
- 2026: 18 · 2025: 30 · 2024: 31 · 2023: 28 · 2022: 19 · 2021: 35 · 2020: 30 · 2019: 16 · 2018: 32 · 2017: 24 · 2016: 38 · 2015: 29 · 2014: 37 · 2013: 33 · 2012: 38
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (N01-HV-92922)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- hypertension incidence, hypertension prevalence, young adults, adiposity, obesity, heart rate, triglycerides, alcohol consumption, hematocrit, sex differences, weight management, hypertension risk factors, Framingham Offspring Study
- MeSH terms
- Adult, Alcohol Drinking, Blood Pressure, Female, Humans, Hypertension, Lipids, Male, Middle Aged, Obesity, Risk, Smoking
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