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Table 4 Overview of longitudinal studies on the association between PA and the outcome of hypertension

From: The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a systematic review of longitudinal studies published after 2012

AuthorCountryCharacteristicsFollow-up timePredictor variable: Physical activityOutcome of interestMain results
Cohen et al. (2012) [48]USA (Nurses’ Health Study I cohort)N = 78,590 women; 49 years (IQR 44–56)20 yearsSelf-reported PAIncident hypertension (self-reported; validated in NHS I cohort)Association between PA and incident hypertension varies by age (p-value for interaction < 0.001).
Baseline: 1984METs/wk for vigorous exercise in quintiles (Q1–5)
Follow-up: 2004HR [95% CI] lowest for PA Q5 as compared to Q1.
- Age ≥ 50: Q1 1.0 (reference); Q2 1.00 [0.91, 1.11]; Q3 1.03 [0.94, 1.14]; Q4 1.01 [0.91, 1.12]; Q5 0.87 [0.78, 0.97]
- Age 51–60: Q1 1.0 (reference); Q2 0.94 [0.88, 1.00]; Q3 0.94 [0.88, 1.00]; Q4 0.91 [0.85, 0.97]; Q5 0.86 [0.80, 0.92]
- Age ≥ 61: Q1 1.0 (reference); Q2 1.03 [0.97, 1.09]; Q3 0.98 [0.93, 1.04]; Q4 0.99 [0.93, 1.05]; Q5 0.95 [0.90, 1.01]
Lu et al. (2015) [45]ChinaN = 1009, 35.48 ± 0.19 years, 63.4% malesMedian 4.7 yearsSelf-reported PAIncident hypertensionNo significant association between PA and risk of hypertensiona: HR [95% CI]
- Frequent
Base line: 2004- Occasional- Occasional: 0.74 [0.40, 1.39]
Follow-up: 2012- Everyday- Frequent: 0.96 [0.51, 1.83]
- Everyday: 1.0 (reference)
Medina et al. (2018) [49]Mexico (Mexico City Diabetes Study)N = 1541, median 45 (IQR 39–52) years; 45.1% malesMedian 11.8 yearsSelf-reported PA (occupational, leisure, total activity in MET-min/wk of MVPA)Incident hypertension (measured by study team)Participants with < 1 MET-min/wk of leisure (HR 1.37 [95% CI 1.07, 1.75], p = 0.015) or occupational MVPA (HR 1.52 [1.17, 1.97], p = 0.001) had increased risk of hypertension as compared to reference group (≥ 1200 MET-min/wk)b
Baseline: 1989–1990
- 1 = < 1
Follow-up: 1993–1994, 1997–1998, 2008–2009- 2 = 1–599.9No association was observed between total PA and hypertension.
- 3 = 600–1199.9
- 4 = ≥ 1200
Pavey et al. (2013) [46]Australia (Australian Longitudinal Study on Women’s Health)N = 11,285 women, mean age 49.5 yearsBaseline: 1998Self-reported PA (MET-min/wk)Occurrence of hypertension (self-reported)OR [95% CI] for hypertension declined with increasing PA volume; decline slightly greater in MVPA than MPA group
MPAc | MVPAc:
Follow-up: 2001, 2004, 2007, 2010- None
- > 0- < 250
- 250- < 500- None: 1.0 (reference)
- 500- < 1000- > 0- < 250: 0.92 [0.83, 1.02] | 0.87 [0.63, 1.04]
- 1000- < 1500- 250- < 500: 0.90 [0.81, 1.00] | N.A.
- 1500- < 2000- 500- < 1000: 0.82 [0.75, 0.91] | 0.73 [0.62, 0.86]
- > 2000- 1000- < 1500: 0.74 [0.66, 0.82] | 0.65 [0.55, 0.76]
- Inactive- 1500- < 2000: 0.78 [0.68, 0.90] | 0.63 [0.54, 0.74]
- Moderate (MPA)- > 2000: 0.80 [0.70, 0.93] | 0.56 [0.49, 0.64]
- Moderate and vigorous activity (MVPA)
Stenehjem et al. (2018) [47]Norway (Nord- Trøndelag Health Study)N = 21,892, 42.7% males11 yearsSelf-reported LTPAIncident hypertension (measured by study team)Risk of hypertension not associated with LTPA total scored: RR [95% CI]
Baseline: 1984–1986Total score
- LowWomen | Men
Follow-up: 1995–1997- Medium- Low: 1.0 (reference)
High- Medium: 0.98 [0.92, 1.05] | 0.96 [0.90, 1.03]
Frequency (per wk)- High: 0.96 [0.90, 1.01] | 0.97 [0.90, 1.03] p = 0.138 | p = 0.276
- None
- < 1Frequency of PA associated with reduced risk of hypertension only in males (≥4/wk: RR 0.87 [0.78, 0.98]).
Obese males with high PA have lower risk of hypertension (RR 1.16 [0.79, 1.70]) than obese males with low PA (RR 1.50 [1,27, 1.77]).
- 1
- 2–3
- ≥4
IntensityObese females with low PA have increased risk of hypertension (RR 1.55 [1.35, 1.77]).
- None
- Low
- Medium/high
Williams & Thompson (2012) [50]USAN = 43,893Median 6.2 yearsSelf-reported PAIncident hypertensionGreater MET-h/d is associated with lower risk of incident hypertension: HR [95% CI]e
MET-h/d
Baseline: 1998–1999- Light- Running: 0.958 [0.94, 0.97]
- Moderate- Walking: 0.928 [0.899, 0.957]
Follow-up: 2006- Vigorous- Other vigorous: 0.98 [0.97, 0.99]
- Other moderate: 0.997 [0.976, 1.018]
- Other light: 0.886 [0.739, 1.006]
  1. Abbreviation: CI confidence interval, d day, h hour, HR hazard ration, IQR interquartile range, LTPA leisure time physical activity, MET metabolic equivalent, min minutes, MPA moderate physical activity, MVPA moderate to vigorous physical activity, N number of participants, N.A. not available, p p-value, PA physical activity, RR relative risk, SE standard error, wk week
  2. a: Model adjusted for age, gender and follow-up time; b Model adjusted for sex*time, age, education levels, marital status, current smoking, alcohol intake*time, total energy intake, sleeping hours, leisure/ working METs/min/wk; c Model adjusted for sociodemographic (age, education, marital status, area of residence), behavioral (smoking, alcohol, and sitting), chronic conditions covariates; d Model adjusted for age, marital status, education, smoking, alcohol frequency last 2 weeks, BMI, PA summary score; e Model adjusted for baseline age (age, age2), sex, race, education, smoking, intakes of red meat, fruit, alcohol, preexisting CHD at baseline
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