Prognostic Factors of New-Onset Hypertension in New and Traditional Hypertension Definition in a Large Taiwanese Population Follow-up Study

The aim of this study was to determine the predictors of new-onset hypertension when the definition of hypertension is changed from the traditional definition (140/90 mmHg) to a new definition (130/80 mmHg). Using data from the Taiwan Biobank, a total of 17,072 and 21,293 participants in the new and traditional definition groups were analyzed, respectively. During a mean follow-up period of 3.9 years, 3641 and 3002 participants developed hypertension in the new and traditional definition groups, respectively. After multivariable analysis, older age (OR, 1.035; 95% CI, 1.030 to 1.039; < 0.001), male sex (OR, 1.332; 95% CI, 1.194 to 1.486; < 0.001), high systolic blood pressure (SBP) (OR, 1.067; 95% CI, 1.062 to 1.073; < 0.001), high diastolic blood pressure (DBP) (OR, 1.048; 95% CI, 1.040 to 1.056; < 0.001), high heart rate (OR, 1.007; 95% CI, 1.002 to 1.012; = 0.004), high body mass index (BMI) (OR, 1.091; 95% CI, 1.077 to 1.106; < 0.001), high fasting glucose (OR, 1.004; 95% CI, 1.001 to 1.006; = 0.002), and high triglycerides (OR, 1.001; 95% CI, 1.000 to 1.001; = 0.004) were significantly associated with new-onset hypertension in the new definition group. In the traditional definition group, the predictors of new-onset hypertension were older age (OR, 1.038; 95% CI, 1.032 to 1.043; < 0.001), high SBP (OR, 1.078; 95% CI, 1.072 to 1.084; < 0.001), high DBP (OR, 1.039; 95% CI, 1.031 to 1.046; < 0.001), high heart rate (OR, 1.005; 95% CI, 1.000 to 1.010; = 0.032), high BMI (OR, 1.072; 95% CI, 1.058 to 1.087; < 0.001), high fasting glucose (OR, 1.003; 95% CI, 1.000 to 1.005; = 0.020), low cholesterol (OR, 0.998; 95% CI, 0.997 to 0.999; = 0.004), high triglycerides (OR, 1.001; 95% CI, 1.000 to 1.001; = 0.001), and low estimated glomerular filtration rate (eGFR) (OR, 0.995; 95% CI, 0.993 to 0.997; < 0.001). In conclusion, older age, high SBP and DBP, high heart rate, high BMI, high fasting glucose, and high triglycerides were useful predictors of new-onset hypertension in both the new and traditional definition groups. However, male sex was a significant predictor of new-onset hypertension only in the new definition group, and low cholesterol and low eGFR were significant predictors of new-onset hypertension only in the traditional definition group. Hence, changing the diagnostic cut-off value for hypertension may have a significant impact on the association of some clinical and laboratory parameters with new-onset hypertension.