We aimed to determine the association between ideal cardiovascular health metrics (ICVHM) and the incidence of hypertension among Iranian adults. The study population included 5409 Iranian adults aged ≥20 years (2088 men) without hypertension (applying the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline) at baseline. The ICVHM was defined according to the AHA’s 2020 impact goals, excluding total cholesterol was replaced by non-HDL cholesterol (non-HDL-C). Multivariable Cox proportional hazards regression analysis was done to estimate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. During a median 8.5-year follow-up, 2972 new cases of hypertension were identified (men: 1,287). Non-HDL-C < 130 mg/dL in men [HR (95% CI): 0.75(0.65–0.86)] and fasting plasma glucose(FPG) < 100 mg/dL in women[HR (95% CI): 0.79(0.64–0.97)], and among both genders, being normal/overweigth status (compared to obese) and blood pressure <120/80 mmHg were associated with a lower risk for hypertension. Additionally, in both gender, a 1-point increase in the number of global ICVHM decreased the risk of hypertension by more than 10%, and having ≥5 vs. <2 ICVHM, were associated with a lower risk of hypertension by 30% (all p values < 0.05). Applying the JNC 7 guideline, the association between ICVHM, with incident hypertension, were generally similar. Having a higher number of ICVHM was associated with a lower risk of incident hypertension, using both 2017 ACC/AHA and JNC 7 guidelines, mostly attributable to keeping the ideal status of body mass index, non-HDL-C, and FPG.

我们的目的是确定理想心血管健康指标 (ICVHM) 与伊朗成年人高血压发病率之间的关联。研究人群包括 5409 名 20 岁以上的伊朗成年人（2088 名男性），基线时没有高血压（采用 2017 年美国心脏病学会 (ACC)/美国心脏协会 (AHA) 指南）。 ICVHM 是根据 AHA 2020 年影响目标定义的，不包括被非 HDL 胆固醇（非 HDL-C）取代的总胆固醇。进行多变量 Cox 比例风险回归分析，以估计 ICVHM 作为连续变量和分类变量的风险比 (HR)。在中位 8.5 年的随访期间，发现了 2972​​ 例新的高血压病例（男性：1,287 例）。非HDL-C <男性 130 mg/dL [HR (95% CI): 0.75(0.65–0.86)] 且空腹血糖 (FPG) <女性中 100mg/dL[HR (95% CI): 0.79(0.64–0.97)]，并且在两性中，正常/超重状态（与肥胖相比）和血压 <120/80mmHg 与降低患高血压的风险。此外，无论性别，总体 ICVHM 数量每增加 1 个百分点，高血压风险就会降低 10% 以上，并且 ICVHM ≥5 与 <2 的情况与高血压风险降低 30% 相关（所有 p 值 < 0.05）。应用 JNC 7 指南，ICVHM 与高血压事件之间的关联总体相似。根据 2017 年 ACC/AHA 和 JNC 7 指南，ICVHM 数量较高与高血压发生风险较低相关，这主要归因于保持体重指数、非 HDL-C 和 FPG 的理想状态。