Key result
High physical activity is linked to ~19% lower incident hypertension risk vs. lowest activity.
Why the study?
The degree to which total physical activity and its changes benefit normotensives and hypertensives in preventing and managing hypertension is uncertain.
Cohort (n=73,077)
Yes
Hazard Ratio: 0.81 (95% CI 0.77–0.86)
Absolute Event Rate: 29.01% vs 34.1%
p-value: p=<0.001
Supports activity to lower hypertension risk; leaves open causality in randomized trials.
OBJECTIVES: Moderate to vigorous physical activity is recommended to prevent hypertension according to the current guidelines. However, the degree to which the total physical activity (TPA) and its changes benefit normotensives and hypertensives is uncertain. We aimed to examine the effects of TPA and its changes on the incidence, progression, and remission of hypertension in the large-scale prospective cohorts. METHODS: A total of 73,077 participants (55,101 normotensives and 17,976 hypertensives) were eligible for TPA analyses. During a mean follow-up of 7.16 years (394,038 person-years), 12,211 hypertension cases were identified. TPA was estimated as metabolic equivalents and categorized into quartiles. Cox proportional hazards regression and multivariable logistic regression were used to estimate associations of TPA and changes in TPA with incident hypertension and progression/remission of hypertension. RESULTS: Compared with the lowest quartile of TPA, normotensives at the third and the highest quartile had a decreased risk of incident hypertension, with hazard ratios (HRs) of 0.86 [95% confidence interval (CI): 0.81-0.91] and 0.81 (95% CI: 0.77-0.86), respectively. Hypertensives at the highest quartile of TPA demonstrated a decreased risk of progression of hypertension [odds ratio (OR) = 0.87, 95% CI: 0.79-0.95], and an increased probability of hypertension remission (OR = 1.17, 95% CI: 1.05-1.29). Moreover, getting active from a sedentary lifestyle during the follow-up period could reduce 25% (HR = 0.75, 95% CI: 0.58-0.96) risk of incident hypertension, whereas those becoming sedentary did not achieve benefit from initially being active. CONCLUSIONS: Our findings indicated that increasing and maintaining TPA levels could benefit normotensives, whereas higher TPA levels were needed to effectively control progression and improve remission of hypertension. Physical activity played undoubtedly an essential role in both primary and secondary prevention of hypertension.
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Cai et al. (2021) conducted a cohort in Hypertension (n=73,077). Total physical activity (highest quartile) vs. Lowest quartile of total physical activity was evaluated on Incident hypertension (among baseline normotensives) (HR 0.81, 95% CI 0.77-0.86, p=<0.001). The highest quartile of total physical activity decreased the risk of incident hypertension by 19% compared with the lowest quartile among normotensive adults (HR 0.81).
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