ArticleFrontiers in cardiovascular medicine2026
Sex-specific associations between hemoglobin levels and incident hypertension among physically fit young adults.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hemoglobin (Hb) levels have uncertain associations with blood pressure (BP). In addition, no cohort studies to date have investigated the association between Hb and hypertension among physically fit young adults. Methods: This cohort study involved 2,440 military male and female personnel, aged 18-39 years, free of baseline hypertension in Taiwan in 2014. The individuals were followed up for incident hypertension from baseline to 2020. All participants received military health examinations annually, including BP measurements. Hypertension was defined as a mean systolic BP ≥130 mmHg and/or a mean diastolic BP ≥80 mmHg, in accordance with the latest guidelines. Mild anemia was defined as Hb concentrations of 10.0-13.9 g/dL in men and 10.0-11.9 g/dL in women. Multivariable Cox regression analyses were performed, adjusting for age, sex, BP, body mass index, substance use status, serum uric acid, blood urea nitrogen, estimated glomerular filtration rate, physical activity and fitness to determine the relationships. Results: A total of 915 participants (37.5%) developed new-onset hypertension during the follow-up period. Of the 2,440 participants, 2,148 were men and 292 were women, and new-onset hypertension occurred in 871 men and 44 women. In men, Hb levels (per 1.0 g/dL increase) were positively associated with incident hypertension [hazard ratio (HR) and 95% confidence interval (CI): 1.105 (1.026-1.190)], and mild anemia was linked to a lower risk of incident hypertension [HR: 0.765 (0.597-0.979)]. The association of Hb in men were only significant for isolated diastolic hypertension [HRs: 1.176 (1.047-1.320) and 0.514 (0.325-0.813), respectively]. In young women, the associations of Hb levels and mild anemia with incident hypertension were not statistically significant (HRs: 0.765 and 1.713, both Conclusions: Hb levels were positively associated with increased risk of hypertension among physically fit young male adults. Such association was specifically for isolated diastolic hypertension. However, among women, neither association reached significance, possibly due to the small number of hypertension events making these results uncertain.
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