Physical activity provides cardioprotection across blood pressure levels

Physical activity confers cardioprotective benefits at all levels of blood pressure, such that it reduces the risks of cardiovascular events and mortality in both hypertension and prehypertension, a study has found.

The study population comprised 18,974 white men and women aged 20–98 years. All participants completed the Physical Activity Questionnaire to provide data on activity level in leisure time (level I: inactivity; II: light activity; and III: moderate/high-level activity). Of the participants, 3,483 were inactive, 9,692 had light activity and 5,715 had moderate-to-high level activity.

Over a mean follow-up time of 23.4 years, there were 13,355 deaths and 9,470 cardiovascular events recorded. There was a dose-response association between physical activity sand the risk of all-cause mortality in a dose-response pattern at all levels of blood pressure (normal: <120/<80 mm Hg; prehypertension: 120–139/80–89 mm Hg; stage I hypertension: 140–159/90–99 mm Hg; stage II hypertension: ≥160/≥100 mm Hg).

The pattern of association remained unchanged despite controlling for the following confounders: sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index and calendar time. For example, among individuals with stage I hypertension, the risk of mortality decreased with light physical activity level (hazard ratio, 0.78, 95 percent CI, 0.72–0.84), and moderate/high-level activity (HR, 0.69,0.63–0.75) compared with inactivity (p-both<0.001).

The findings highlight the importance of regular physical activity in the management of individuals with hypertension and prehypertension, according to researchers. The takeaway is that light physical activity levels, which almost everyone can perform, are responsible for most of the health benefits at all levels of BP, including stage II hypertension.

Therefore, clinicians and other health professionals should encourage patients with hypertension and prehypertension to be physically active at the level of the patient’s capability, they added.