Stoutenburg Eric G, Bravo Maria C, Howard Virginia J, Judd Suzanne E, Long D Leann, Plante Timothy B
Larner College of Medicine at the University of Vermont, Burlington, Vermont.
Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont.
J Hypertens. 2025 Aug 1;43(8):1373-1380. doi: 10.1097/HJH.0000000000004045. Epub 2025 May 14.
Hypertension is a cardiovascular disease risk factor disproportionately affecting Black adults. Certain biomarkers of thrombosis and inflammation are associated with a greater risk of hypertension. Factor IX is a marker of thrombosis; Black adults have higher levels than others. Whether factor IX correlates with incident hypertension risk or explains some of the disproportionate burden faced by Black adults, is not known.
REasons for Geographic and Racial Differences in Stroke (REGARDS) recruited 30 239 Black and White adults from the contiguous US in 2003-2007 (Visit 1) and had repeat assessment in 2013-2016 (Visit 2). Factor IX was measured in Visit 1 samples in a sex-race stratified sample of 4400 participants that attended both visits. Modified Poisson regression estimated adjusted risk ratios (RR) for incident hypertension at Visit 2 by factor IX tertiles. Inverse odds ratio weighting estimated the proportion of the excess burden of incident hypertension in Black adults due to factor IX levels.
Among 1824 participants (55% female and 24% Black race), 36% developed hypertension. The fully adjusted RR for the third vs. first tertile was 1.21; 95% confidence interval (CI) 1.03-1.43, and there was a significant linear trend across tertiles ( P < 0.001). Factor IX did not mediate excess hypertension risk among Black adults in adjusted models.
In this prospective study of Black and White adults without prevalent hypertension, higher factor IX was associated with a greater risk of incident hypertension. This risk may relate to adverse thromboinflammation among persons in the 2nd and 3rd tertiles of factor IX.
高血压是一种心血管疾病风险因素，对成年黑人的影响尤为严重。某些血栓形成和炎症的生物标志物与高血压风险增加有关。凝血因子IX是血栓形成的标志物；成年黑人的凝血因子IX水平高于其他人。目前尚不清楚凝血因子IX是否与高血压发病风险相关，或者是否能解释成年黑人面临的部分不成比例的负担。
中风地理和种族差异原因（REGARDS）研究在2003 - 2007年（第1次访视）从美国本土连续招募了30239名黑人和白人成年人，并在2013 - 2016年进行了重复评估（第2次访视）。在第1次访视时对4400名两次访视均参加的按性别和种族分层的样本进行了凝血因子IX检测。采用修正泊松回归按凝血因子IX三分位数估计第2次访视时高血压发病的调整风险比（RR）。采用逆概率比加权法估计由于凝血因子IX水平导致成年黑人高血压发病额外负担的比例。
在1824名参与者（55%为女性，24%为黑人）中，36%患了高血压。第三分位数与第一分位数相比，完全调整后的RR为1.21；95%置信区间（CI）为1.03 - 1.43，且三分位数间存在显著线性趋势（P < 0.001）。在调整模型中，凝血因子IX并未介导成年黑人中额外的高血压风险。
在这项对无高血压病史的黑人和白人成年人的前瞻性研究中，较高的凝血因子IX与高血压发病风险增加相关。这种风险可能与凝血因子IX第二和第三分位数人群中的不良血栓炎症有关。
