Predicting short-term blood pressure trajectories using lifestyle and behavioural factors: a prospective cohort study.

Background

Hypertension is a major contributor to cardiovascular morbidity and mortality. While lifestyle modification is central to prevention, evidence on short-term blood pressure (BP) dynamics in relation to behavioural factors remains limited.

Objective

To evaluate the influence of diet, physical activity, and psychological stress on systolic blood pressure (SBP) trajectories and to develop a regression-based model for short-term BP prediction.

Methods

In this 12-week prospective cohort study, 75 adults attending a preventive cardiology clinic were followed, with BP measured at baseline, 6 weeks, and 12 weeks using validated oscillometric methods. Lifestyle and behavioural factors were assessed using the Food Frequency Questionnaire (sodium intake and DASH adherence), IPAQ-SF (physical activity), and PSS-10 (stress). Linear mixed-effects regression identified predictors of SBP change, and Elastic Net regression predicted 12-week SBP.

Results

Sixty-seven participants (mean age 44.6 ± 10.8 years; 52.2% male) completed follow-up. Mean SBP declined from 134.2 ± 12.6 to 131.4 ± 11.5 mmHg. Higher physical activity and DASH adherence were associated with SBP reduction, whereas higher sodium intake and stress predicted SBP elevation (all p < 0.05). The Elastic Net model demonstrated strong predictive performance (R 2 = 0.78; RMSE = 5.9 mmHg). Physical activity had a stronger effect in participants <45 years, and stress amplified sodium-related SBP increases.

Conclusions

Short-term SBP trajectories are strongly influenced by modifiable behavioural factors. Predictive models based on lifestyle data may support early risk stratification and personalized hypertension prevention.