ISSN 1671-5411 CN 11-5329/R
Volume 18 Issue 3
Mar.  2021
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Please cite this article as: CAI C, LIU FC, LI JX, HUANG KY, YANG XL, CHEN JC, LIU XQ, CAO J, CHEN SF, SHEN C, YU L, LU FH, WU XP, ZHAO LC, LI Y, HU DS, HUANG JF, ZHOU XY, LU XF, GU DF. Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension. J Geriatr Cardiol 2021; 18(3): 175−184. DOI: 10.11909/j.issn.1671-5411.2021.03.002
Citation: Please cite this article as: CAI C, LIU FC, LI JX, HUANG KY, YANG XL, CHEN JC, LIU XQ, CAO J, CHEN SF, SHEN C, YU L, LU FH, WU XP, ZHAO LC, LI Y, HU DS, HUANG JF, ZHOU XY, LU XF, GU DF. Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension. J Geriatr Cardiol 2021; 18(3): 175−184. DOI: 10.11909/j.issn.1671-5411.2021.03.002

Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension

doi: 10.11909/j.issn.1671-5411.2021.03.002
Funds:  This study was supported by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (2019-I2M-2-003 and 2017-I2M-1-004), National Key Research & Development Program of China (2018YFE0115300 and 2017YFC0211700, and 2017YFC0908401), and the National Natural Science Foundation of China (91643208). The sources of funding had no role in study design, data collection, analyses, interpretation, and decision to submit the article for publication
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  •  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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