Key result
Higher hemoglobin linked to ~11% greater incident hypertension risk per 1.0 g/dL in fit men.
Why the study?
The associations between hemoglobin levels and blood pressure, particularly incident hypertension among physically fit young adults, were uncertain and uninvestigated in cohort studies.
Do higher hemoglobin levels increase the risk of incident hypertension in physically fit young adults?
Cohort (n=2,440)
No
Do higher hemoglobin levels increase the risk of incident hypertension in physically fit young adults?
Higher hemoglobin levels are associated with a greater risk of incident isolated diastolic hypertension in physically fit young men, whereas mild anemia is protective, highlighting a potential role of hematologic indices in vascular resistance.
Answers are grounded in this paper and cite their sources.
Higher hemoglobin may flag hypertension risk in fit young men but should not change practice; leaves open causality and need for prospective studies.
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 p > 0.05). 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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Tsai et al. (2026) conducted a cohort in Incident hypertension (n=2,440). Hemoglobin levels (per 1.0 g/dL increase) vs. Lower hemoglobin levels was evaluated on Incident hypertension (≥stage 1) in men (HR 1.105, 95% CI 1.026-1.190, p=0.008). In physically fit young men, each 1.0 g/dL increase in baseline hemoglobin levels was associated with a higher risk of incident hypertension.
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