# Analysis of Related Factors Influencing Hypertension Classification among Centenarians in Hainan, China

## TL;DR

This study identifies BMI, LDL cholesterol, and ethnicity as key factors influencing hypertension severity in centenarians from Hainan, China.

## Contribution

The study provides novel insights into hypertension grading factors specific to centenarians in a Chinese population.

## Key findings

- Low BMI (below 18.5 kg/m2) is associated with reduced risk of higher hypertension grades.
- Elevated LDL cholesterol significantly increases progression to severe hypertension.
- Li ethnicity is linked to higher risk of hypertension grade progression compared to Han ethnicity.

## Abstract

As a population ages, blood pressure levels gradually
increase, leading to a higher incidence of hypertension and increased
cardiovascular diseases risk. This study examines factors affecting hypertension
grading among centenarians in the Hainan Province.

Data from
2014 to 2016 were accessed from the cross-sectional database “Hypertension
Levels and Epidemiological Characteristics of the Elderly and Centenarians in
Hainan province of China”. This study included 690 centenarians with
hypertension. Hypertension grading was the dependent variable, analyzed against
independent variables including demographic information (sex, age, ethnicity,
education level, marital status, cohabitation, and regional distribution),
lifestyle factors (smoking, alcohol consumption, and physical
activity), body mass index (BMI), and comorbid conditions (diabetes and
hyperlipidemia). Logistic regression models, adjusted for these factors, were
used to assess the determinants of hypertension grading among the participants.

Multivariate regression analysis, after adjusting for other
variables, revealed significant associations between BMI, low-density lipoprotein (LDL) levels, and
hypertension grades. Individuals with BMI below 18.5 kg/m2 had a 0.614-fold
lower risk of developing grade III hypertension (odds ratio [OR]: 0.614, 95%
confidence interval [CI]: 0.390–0.966, p = 0.0350) and a 0.586-fold
lower risk for grade II hypertension (OR: 0.586, 95% CI: 0.402–0.852, p = 0.0052). Furthermore, individuals with elevated
LDL levels had a 6.087-fold greater risk of progressing from grade I to grade
III hypertension (OR: 6.087, 95% CI: 1.635–22.660, p = 0.0071) and a
4.356-fold greater risk of progressing from grade II to grade III hypertension
(OR: 4.356, 95% CI: 1.052–18.033, p = 0.0423). Additionally,
individuals of Li ethnicity had 1.823-fold greater risk of progressing from grade
I to grade II hypertension compared to those of Han ethnicity (OR: 1.823, 95%
CI: 1.033–3.218, p = 0.0383).

A BMI below 18.5
kg/m2, elevated LDL, and ethnicity emerged the primary factors associated
with hypertension grading in centenarians. To reduce the risk of hypertension, it
is crucial for centenarians to maintain a healthy weight, normal LDL levels, and
adopt dietary habits including a low-cholesterol and low-fat diet.