High-normal blood pressure in midlife is a stronger risk factor for incident hypertension 26 years later in women than men: the Hordaland Health Study.

PURPOSE: To identify modifiable risk factors in early midlife associated with incident hypertension 26 years later in women and men.

MATERIALS AND METHODS: We used data from 1025 women and 703 men in the community-based Hordaland Health Study examined at the mean age of 42 years (baseline) and after a 26-year follow-up. Patients with hypertension at baseline were excluded. Blood pressure (BP) was classified according to European guidelines. Factors associated with incident hypertension were identified in logistic regression analyses.

RESULTS: At baseline, women had a lower average BP and a lower prevalence of high-normal BP (19% vs 37%, p  < .05). Overall, 39% of women and 45% of men developed hypertension during follow-up ( p  < .05). Among those with high-normal BP at baseline, 72% of women and 58% of men developed hypertension ( p  < .01). In multivariable logistic regression analyses, high-normal BP at baseline was a stronger predictor of incident hypertension in women (odds ratio, OR 4.8, [95% confidence interval, CI 3.4-6.9]) than in men (OR 2.1, [95% CI 1.5-2.8]), p  < .01 for sex interaction. A higher baseline body mass index (BMI) was associated with incident hypertension in both sexes.

CONCLUSIONS: High-normal BP in midlife is a stronger risk factor for developing hypertension 26 years later in women than in men, independent of BMI.