Physical Activity and Clinically Defined Arterial Hypertension in Consecutive Primary Care Patients: A Real-World Cross-Sectional Study

Background: Arterial hypertension (AH) remains a leading modifiable risk factor for cardiovascular disease. Although the inverse association between physical activity (PA) and AH is well established, practice-based evidence from consecutive primary care populations remains clinically relevant for evaluating how this association appears under routine healthcare conditions. Methods: This retrospective cross-sectional study evaluated the association between self-reported PA and clinically defined AH in 1284 adult patients from routine primary care practice. PA was categorized according to World Health Organization recommendations as low (300 min/week). AH was defined as a documented clinical diagnosis and/or ongoing antihypertensive treatment. Logistic regression was used to assess associations between PA category and AH, with adjustment for age, sex, body mass index (BMI), and LDL-C. Results: AH was present in 41.2% of the study population. AH prevalence differed significantly across PA categories, decreasing from 55.9% in the low PA group to 40.8% in the moderate PA group and 26.7% in the high PA group (p < 0.001). Compared with low PA, moderate and high PA were associated with lower odds of AH in crude analysis (OR = 0.54, 95% CI: 0.41–0.71; and OR = 0.29, 95% CI: 0.21–0.39, respectively). These associations remained significant after adjustment for age, sex, BMI, and LDL-C. Conclusions: Higher self-reported PA was associated with lower prevalence of clinically defined AH in consecutive primary care patients. The main contribution of this study is the replication and quantification of this established association in a real-world primary care cohort using pragmatic PA categories and routinely documented AH. Because of the cross-sectional design, these findings should be interpreted as associations and do not establish causality or directionality. Broader physiological and self-regulatory capacity may represent a hypothesis-generating direction for future research, but these processes were not directly measured in this study.