Introduction: Hypertension is the single most important modifiable risk factor for ischemic stroke and also one of the main comorbidities associated with dyslipidemia.
Hypothesis: This study aimed to examine the extent to which dyslipidemia increases the risk of developing hypertension in a Japanese working-age male population.
Methods: We analyzed data from 14,215 non-hypertensive male workers (aged 38 ± 9 years) who underwent annual medical check-ups. Subjects were followed-up for a median of 4 years to determine new-onset hypertension, defined as blood pressure ≥140/90 mmHg or use of antihypertensive medication. The associations between serum lipid levels and the development of hypertension were examined.
Results: During the follow-up period, 1,483 (10.4%) subjects developed hypertension. After adjusting for age, body mass index, impaired fasting glucose/diabetes, baseline blood pressure category, alcohol intake, smoking, exercise, and parental history of hypertension, subjects with a total cholesterol (TC) level ≥222 mg/dL were at a significantly increased risk of developing hypertension (hazard ratio 1.28, 95% CI 1.06–1.56) compared to subjects with a TC level ≤167 mg/dL. Similar results were observed for subjects with high low-density lipoprotein cholesterol (LDLC) and non-high-density lipoprotein cholesterol (HDLC) levels. Intriguingly, a clear U-shaped relationship was found between the HDLC level and the risk of developing hypertension; compared to the third quintile, the multi-adjusted hazard ratio was 1.22 (95% CI 1.03–1.43) in the lowest quintile and 1.34 (95% CI 1.12–1.60) in the highest quintile.
Conclusions: Elevated serum levels of TC, LDLC, and non-HDLC were associated with an increased risk of hypertension in working-age Japanese men. Furthermore, for HDLC, the risk of developing hypertension was increased at both low and high levels.