Relationship Between Urinary tract Stones and Incident Hypertension Among Postmenopausal Women: Results from The Women's Health Initiative.

PURPOSE: To evaluate: whether self-reported urinary tract stones (UTS) are associated with incident hypertension in postmenopausal women in the Women's Health Initiative; potential effect modification by diet-related inflammation and lifestyle factors; whether recurrent UTS further increased risk. METHODS: We conducted a prospective cohort study of 100,562 postmenopausal women aged 50-79 years without baseline hypertension. UTS were self-reported and modeled as a time-varying exposure. Effect modification by the dietary inflammatory index (DII®) and energy-adjusted DII (E- DIITM), physical activity, alcohol consumption, and neighborhood socioeconomic status were evaluated. Incident hypertension was assessed using Cox hazards models adjusted for age and metabolic, lifestyle, socioeconomic, and dietary factors. RESULTS: In unadjusted models, UTS were associated with higher incident hypertension risk (HR = 1.29; 95% CI: 1.11-1.45, p = 0.001) and after full adjustment(HR = 1.16; 95% CI: 1.02-1.35; p =0.05). DII/E-DII did not significantly modify the association (interaction p> 0.20), while physical activity did (interaction p=0.03). Recurrent UTS increased hypertension risk versus no stone history (HR = 1.14; 95% CI: 1.02-1.28; p = 0.03), but not versus a single episode (HR = 1.09; 95% CI: 0.96-1.23; p = 0.18). CONCLUSION: UTS were associated with a modestly increased risk of hypertension in postmenopausal women.