What is the clinical evidence from this study?

Study design: Cohort. Population: Community-dwelling individuals (n=368). Intervention: Vigorous physical activity vs. Lower levels of vigorous physical activity. Primary outcome: Systolic home blood pressure (β -1.69 mmHg, 95% CI -2.24 to -1.13, p=<0.001).

April 3, 2025Open Access

The association between objectively measured physical activity and home blood pressure: a population-based real-world data analysis

Q: What are the key findings of this study?

A 1-hour increase in vigorous physical activity was associated with a 1.69 mmHg reduction in systolic home blood pressure and a 1.09 mmHg reduction in diastolic home blood pressure.

Q: What does this research mean for the field?

A 1-hour increase in vigorous physical activity is associated with a 1.69 mmHg reduction in systolic home blood pressure and a 1.09 mmHg reduction in diastolic home blood pressure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

A 1-hour increase in vigorous physical activity was associated with a 1.69 mmHg reduction in systolic home blood pressure and a 1.09 mmHg reduction in diastolic home blood pressure.

Study Design

Type

Cohort (n=368)

Multicenter

Structured PICO

Does objectively measured physical activity and step count reduce home blood pressure in community-dwelling adults?

Population

368 community-dwelling individuals aged 20 to 74 years without a history of cardiovascular disease, mean age 53.8 years, 58.7% women, based in Masuda, Shimane, Japan. Key exclusions: missing covariates, <500 or >20,000 steps per day, accelerometer wear time <10 h per day, or <5 valid measurement days.

Intervention

Objectively measured physical activity (light, moderate, vigorous), sedentary time, and step count using a validated tri-axial accelerometer.

Outcome

Self-measured home systolic and diastolic blood pressure (average of morning and evening measurements on days the accelerometer was worn).surrogate

Objectively measured higher step counts and longer time spent in vigorous physical activity are associated with modest reductions in home blood pressure, particularly among men and adults under 60 years.

Main Result

Effect estimate: β -1.69 mmHg (95% CI -2.24 to -1.13)

p-value: p=<0.001

Limitations

Participants were from a single local population, limiting generalizability.
A relatively large number of participants were excluded, suggesting potential selection bias.
The accelerometer cannot detect some types of physical activity or posture accurately, potentially misestimating sedentary and light activity time.
The clinical significance of the observed modest effect on home blood pressure may be minimal.
Potential residual confounding from unknown factors such as dietary habits or socioeconomic factors.

Abstract

Few studies have examined the association of objectively measured habitual physical activity (PA) and sedentary behavior with out-of-office blood pressure (BP). We investigated the associations of objectively measured PA intensity time, sedentary time, and step count with at-home BP. Using accelerometer-recorded PA indices and self-measured BP in 368 participants (mean age, 53.8 years; 58.7% women), we analyzed 115,575 records of each parameter between May 2019 and April 2024. PA intensities were categorized as light (2.0-2.9 metabolic equivalents METs); moderate (3.0-5.9 METs); vigorous (≥6.0 METs), or sedentary (<2.0 METs): the median interquartile ranges for these variables was 188 146-232, 83 59-114, 1 0-2, 501 428-579 minutes, respectively, and for step count, was 6040 4164-8457. Means standard deviations for systolic and diastolic BP were 116.4 14.2 and 75.2 9.3 mmHg, respectively. A mixed-effect model adjusted for possible confounders showed that 1-h longer in vigorous PA was associated with lower systolic and diastolic BP (-1.69 and -1.09 mmHg, respectively). A 1000-step increase in step count was associated with lower systolic and diastolic BP (-0.05 and -0.02 mmHg, respectively). Associations were more pronounced among men and participants aged <60 years. Sedentary time was positively associated with BP in men and participants aged <60 years, but inversely associated with BP in women and participants aged ≥60 years. Our findings suggest that more PA and less sedentary behavior were associated with BP reduction, particularly among men and participants aged <60 years. However, the clinical relevance of this effect remains uncertain because of its modest magnitude.

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