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Healthy lifestyle index and its association with hypertension among community adults in Sri Lanka: A cross-sectional study.

Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. Management, Development & Planning Unit, Ministry of Health, Colombo, Sri Lanka. International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan. Graduate School of Public Health, Teikyo University, Tokyo, Japan. The Foundation for Health Promotion, Dehiwala, Sri Lanka. Office for Sri Lanka, World Health Organization Country, Colombo, Sri Lanka. Department of Psychological Medicine, University of Colombo, Colombo, Sri Lanka.

PloS one. 2020;(1):e0226773
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Abstract

OBJECTIVES To investigate the association between a healthy lifestyle index (HLI) (i.e., a composite score comprising multiple lifestyle factors) and hypertension among community adults living in Sri Lanka. METHODS The present study used baseline information of a cluster randomized controlled trial among 456 adults aged 27-65 years in a semi-urban community in Colombo, Sri Lanka. The HLI was constructed by summing a number of low-risk lifestyle factors: low body mass index, sufficient physical activity, non-smoking, low alcohol consumption, and sufficient fruit and vegetable consumption. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of antihypertensive medication. A logistic regression model was used to investigate the association between the HLI (low: 0-2; middle: 3; high: 4-5) and hypertension. RESULTS A total of 178 (39%) participants were hypertensive. Compared with the low HLI group, multivariate-adjusted odds ratios (95% confidence intervals) of hypertension were 0.72 (0.44-1.19) and 0.28 (0.15-0.54) for the middle and high HLI groups, respectively (p-trend <0.001). CONCLUSIONS The present study provides essential evidence on an inverse association between adherence to healthy lifestyles and hypertension.