Plasma Leptin and Blood Pressure Progression in Blacks: The Jackson Heart Study

Data on the relation of plasma leptin with blood pressure (BP) progression among Blacks are scant. We evaluated the association of plasma leptin levels with BP progression and incident hypertension among Blacks. We analyzed a total of 1190 Jackson Heart Study participants without hypertension at baseline (2000-2004) who attended ≥1 follow-up visit (2005-2008 or 2009-2013). Modified Poisson regression was used to generate multivariable-adjusted risk ratios (RRs) and 95% CIs for BP progression (an increase by ≥1 BP category) and incident hypertension (BP ≥130/80 or use of antihypertensive medication). Of the 1190 participants, 64.1% were women (n=763), mean age was 48 (SD: 12) years. Over a median of 7 years, 71.3% progressed to a higher BP category (n=848) and 64.6% developed hypertension (n=769). After adjusting for confounders, each SD increment in log-leptin was associated with higher risks of BP progression (RR, 1.10 [95% CI, 1.03-1.18], P=0.007) and incident hypertension (RR, 1.14 [95% CI, 1.05-1.23], P=0.002). Compared with those in the lowest leptin quartile, participants in the highest quartile had significantly higher risks of BP progression (RR, 1.27 [95% CI, 1.05-1.54], P_trend=0.007) and incident hypertension (RR, 1.32 [95% CI, 1.07-1.64], Ptrend=0.010). These associations were consistent across multiple BP classifications. Our findings from a large cohort of Blacks support the notion that plasma leptin concentrations may help identify an at-risk population that could be targeted for hypertension prevention and management strategies in future studies.