We aimed to explore the association between the efficiency score and the risk of hypertension. We conducted a prospective cohort study of 2412 adults aged 40 years or above without hypertension in Guizhou, China from 2010 to 2020. The data envelopment analysis input-oriented DEA-CCR model was used to calculate the efficiency scores. The Cox regression model was used to assess the relationship between the efficiency score and incident hypertension. The dose-response relationship was evaluated by restricted cubic spline. Quantile regression was used to analyze the effect of efficiency scores on SBP and DBP. A total of 857 new hypertension cases were identified with a mean follow-up of 6.88 years. The efficiency score was lower in the new hypertension cases than participants without hypertension (0.70 vs. 0.67). After adjusting for possible confounding factors, the HR of hypertension risk was 0.20 (95%CI: 0.09, 0.42) for per 0.1 increase in the efficiency score. The dose-response relationship showed a non-linear relationship between the efficiency score and hypertension risk. Our results showed that the efficiency score was a cost-effective tool to identify those at a high risk of hypertension, and suggested targeted preventive measures should be undertaken.
Keywords: cohort study; efficiency score; hypertension.