Association between healthy lifestyles and hypertension in Tibetan nomads and the mediating role of HOMA-IR
Objective To investigate the association between healthy lifestyle and hypertension among Tibetan herders in Qinghai Province,providing evidence for the prevention and control of chronic diseases in ethnic minorities.Methods An open cohort design was employed,involving questionnaire surveys and health examinations among the study participants.Healthy lifestyle factors included non-smoking,non-drinking,healthy eating habits,and the absence of overweight,obesity,and central obesity.A mixed-effects model was used to explore the relationship between healthy lifestyle scores and hypertension,along with a mediation analysis of the homeostasis model assessment insulin resistance index(HOMA-IR).Results A total of 1 930 Tibetan adults were included in the study,among whom 1 052 individuals(54.51％)had a healthy lifestyle score of 3 or less,while 878 individuals(45.49％)had a score of 4 or higher.501 cases(25.96％)of hypertension were found.After adjusting fordemographic characteristics and socioeconomic factors,a higher healthy lifestyle score was associated with a lower prevalence of hypertension.A healthy lifestyle(score ≥5)was associated with a reduced risk of hypertension(OR=0.47,95％CI:0.26-0.85).Further adjustment for altitude revealed an even greater reduction in hypertension risk(OR=0.42,95％CI:0.22-0.81).Each one-level improvement in lifestyle was associated with a 23％reduction in hypertension risk on average.Subgroup analysis indicated that a higher healthy lifestyle score was significantly associated with reduced hypertension risk at extremely high altitudes(OR=0.13,95％CI:0.04-0.41).Mediation analysis demonstrated that HOMA-IR mediated the relationship between a healthy lifestyle and hypertension.Conclusions Adherence to a healthy lifestyle among Tibetan nomads in Qinghai is associated with a reduced risk of hypertension.Maintaining a healthy lifestyle is significant for reducing the burden of chronic diseases and enhancing the prevention and treatment of chronic diseases among nomads.
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