A greater reduction in γ-GTP was associated with achieving BP <140/90 mmHg without antihypertensive medication among individuals who newly developed Grade I hypertension.

BACKGROUND: Our previous multivariable analysis of hypertensive participants in Hiratsuka City identified younger age, grade I hypertension, absence of prior hypertension at the previous specific health check-up (SHC), and willingness to improve lifestyle as key determinants of achieving target blood pressure (BP). Building on these findings, we further characterized participants who achieved BP control without antihypertensive medications to identify responders for lifestyle guidance using decision-tree analysis.

METHODS: The study included 5428 residents age 40-74 years with hypertension (BP ≥140/90 mmHg) but untreated at SHCs conducted from May 2016 to March 2023. Of these, 2468 participants started antihypertensive medications by their next SHC. Descriptive analysis and decision-tree analysis stratified by antihypertensive medication use were used to identify factors associated with achieving BP <140/90 mmHg and to assess their relative importance.

RESULTS: Among participants without antihypertensive medications, 55.9% achieved BP <140/90 mmHg. Decision-tree analysis revealed that no history of hypertension at the previous SHC and lower BP grade were the primary predictors of success. Notably, a reduction in γ-glutamyl transpeptidase (γ-GTP) was the next most influential factor in the non-medication group. For individuals who initiated antihypertensive therapy, younger age was associated with higher achievement rates.

CONCLUSION: A greater reduction in γ-GTP was associated with achieving BP <140/90 mmHg without antihypertensive medication, among individuals who newly developed Grade I hypertension, suggesting that effective lifestyle modification, reflected by improvements in metabolic markers, may play a pivotal role in BP control in this population.