{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:12:23Z","timestamp":1790143943361,"version":"4.0.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019813","name":"Hualien Armed Forces General Hospital","doi-asserted-by":"publisher","award":["HAFGH-D-115004"],"award-info":[{"award-number":["HAFGH-D-115004"]}],"id":[{"id":"10.13039\/100019813","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemoglobin (Hb) levels have uncertain associations with blood pressure (BP). In addition, no cohort studies to date have investigated the association between Hb and hypertension among physically fit young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study involved 2,440 military male and female personnel, aged 18\u201339 years, free of baseline hypertension in Taiwan in 2014. The individuals were followed up for incident hypertension from baseline to 2020. All participants received military health examinations annually, including BP measurements. Hypertension was defined as a mean systolic BP \u2265130\u2005mmHg and\/or a mean diastolic BP \u226580\u2005mmHg, in accordance with the latest guidelines. Mild anemia was defined as Hb concentrations of 10.0\u201313.9\u2005g\/dL in men and 10.0\u201311.9\u2005g\/dL in women. Multivariable Cox regression analyses were performed, adjusting for age, sex, BP, body mass index, substance use status, serum uric acid, blood urea nitrogen, estimated glomerular filtration rate, physical activity and fitness to determine the relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 915 participants (37.5%) developed new-onset hypertension during the follow-up period. Of the 2,440 participants, 2,148 were men and 292 were women, and new-onset hypertension occurred in 871 men and 44 women. In men, Hb levels (per 1.0\u2005g\/dL increase) were positively associated with incident hypertension [hazard ratio (HR) and 95% confidence interval (CI): 1.105 (1.026\u20131.190)], and mild anemia was linked to a lower risk of incident hypertension [HR: 0.765 (0.597\u20130.979)]. The association of Hb in men were only significant for isolated diastolic hypertension [HRs: 1.176 (1.047\u20131.320) and 0.514 (0.325\u20130.813), respectively]. In young women, the associations of Hb levels and mild anemia with incident hypertension were not statistically significant (HRs: 0.765 and 1.713, both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hb levels were positively associated with increased risk of hypertension among physically fit young male adults. Such association was specifically for isolated diastolic hypertension. However, among women, neither association reached significance, possibly due to the small number of hypertension events making these results uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1902865","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:57Z","timestamp":1790142597000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-specific associations between hemoglobin levels and incident hypertension among physically fit young adults"],"prefix":"10.3389","volume":"13","author":[{"given":"Kun-Zhe","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Medicine, Hualien Armed Forces General Hospital","place":["Hualien City, Taiwan"]},{"name":"Department of Stomatology of Periodontology, Mackay Memorial Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, Center for Astronautical Physics and Engineering, National Central University","place":["Taoyuan City, Taiwan"]},{"name":"Department of Medical Research, Cathay General Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chiung","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, Center for Astronautical Physics and Engineering, National Central University","place":["Taoyuan City, Taiwan"]},{"name":"Department of Medical Research, Cathay General Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Nung","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hualien Armed Forces General Hospital","place":["Hualien City, Taiwan"]},{"name":"Department of Medicine, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Tsai","family":"Tsai","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University","place":["Taipei, Taiwan"]},{"name":"Cardiovascular Center, Taipei Veterans General Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pingtung Christian Hospital","place":["Pingtung County, Taiwan"]},{"name":"Department of Bussiness Management, National Sun Yat-sen University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen-Min","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hualien Armed Forces General Hospital","place":["Hualien City, Taiwan"]},{"name":"Department of Medicine, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(24)00933-4","article-title":"Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1016\/S0140-6736(24)00685-8","article-title":"Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"B3","year":""},{"key":"B4","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1016\/S0140-6736(08)60655-8","article-title":"International society of hypertension. 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