目的:根据现行指南,建议进行适度至剧烈的体育锻炼以预防高血压。然而,总体力活动(TPA)及其变化对正常高血压患者和高血压患者有益的程度尚不确定。我们的目的是研究TPA及其变化对发病率的影响,programming,以及大规模前瞻性队列中高血压的缓解。
方法:共有73,077名参与者(55,101名正常高血压患者和17,976名高血压患者)符合TPA分析的条件。在平均7.16年(394,038人年)的随访期间,确定了12,211例高血压病例。TPA被估计为代谢当量并被分类为四分位数。使用Cox比例风险回归和多变量逻辑回归来估计TPA和TPA变化与高血压事件和高血压进展/缓解的关联。
结果:与TPA的最低四分位数相比,第三和最高四分位数的Normotensives降低了高血压事件的风险,风险比(HR)为0.86[95%置信区间(CI):0.81-0.91]和0.81(95%CI:0.77-0.86),分别。TPA最高四分位数的高血压患者显示高血压进展风险降低[比值比(OR)=0.87,95%CI:0.79-0.95],高血压缓解概率增加(OR=1.17,95%CI:1.05~1.29)。此外,在随访期间,从久坐的生活方式中积极运动可以降低25%(HR=0.75,95%CI:0.58-0.96)的高血压事件风险,而那些久坐不动的人并没有从最初的活动中获益。
结论:我们的研究结果表明,增加和维持TPA水平可能有益于正常人群,而需要更高的TPA水平来有效控制进展和改善高血压的缓解。体力活动无疑在高血压的一级和二级预防中起着至关重要的作用。
OBJECTIVE: 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.