Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure

Gowsini Joseph; Jacob Louis Marott; Christian Torp-Pedersen; Tor Biering-Sorensen; Gitte Nielsen; Ann-Eva Christensen; Martin Berg Johansen; Peter Schnohr; Peter Sogaard; Rasmus Mogelvang

doi:10.1161/hypertensionaha.119.13786

Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure

Gowsini Joseph, Jacob Louis Marott, Christian Torp-Pedersen, Tor Biering-Sorensen, Gitte Nielsen, Ann-Eva Christensen, Martin Berg Johansen, Peter Schnohr, Peter Sogaard, Rasmus Mogelvang

10 Citationer (Scopus)

Abstract

It has been a challenge to verify the dose of exercise that will produce the maximum health benefits in hypertension. This study aimed to explore the association between level of daily physical activity, all-cause mortality and cardiovascular outcome at different blood pressure levels. A random sample of 18 974 white men and women aged 20 to 98 years were examined in a prospective cardiovascular population study. Self-reported activity level in leisure-time was drawn from the Physical Activity Questionnaire (level I: inactivity; II: light activity; and III: moderate/high-level activity). Blood pressure was defined as normal blood pressure: <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 mean follow-up time was 23.4 +/- 11.7 years. At all levels of blood pressure, higher levels of physical activity were associated with lower all-cause mortality in a dose-response pattern. The pattern remained unchanged after adjustment for following confounders: sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index, and calendar time. Compared with inactivity, following hazard ratios were found for stage I hypertension: light activity, hazard ratio 0.78 (0.72-0.84; P<0.001), moderate/high-level activity, hazard ratio 0.69 (0.63-0.75; P<0.001). At all levels of blood pressure, the risk of cardiovascular events was significantly reduced independent of the level of physical activity. In conclusion, the association between physical activity and all-cause mortality was present in an inverse dose-response pattern at all levels of blood pressure. Physical activity was associated with reduction in cardiovascular events independent of the level of physical activity.

Originalsprog	Engelsk
Tidsskrift	Hypertension
Vol/bind	74
Udgave nummer	6
Sider (fra-til)	1307-1315
ISSN	0194-911X
DOI	https://doi.org/10.1161/hypertensionaha.119.13786
Status	Udgivet - 1 dec. 2019

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title = "Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure",

abstract = "It has been a challenge to verify the dose of exercise that will produce the maximum health benefits in hypertension. This study aimed to explore the association between level of daily physical activity, all-cause mortality and cardiovascular outcome at different blood pressure levels. A random sample of 18 974 white men and women aged 20 to 98 years were examined in a prospective cardiovascular population study. Self-reported activity level in leisure-time was drawn from the Physical Activity Questionnaire (level I: Inactivity; II: Light activity; and III: Moderate/high-level activity). Blood pressure was defined as normal blood pressure: <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 mean follow-up time was 23.4±11.7 years. At all levels of blood pressure, higher levels of physical activity were associated with lower all-cause mortality in a dose-response pattern. The pattern remained unchanged after adjustment for following confounders: Sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index, and calendar time. Compared with inactivity, following hazard ratios were found for stage I hypertension: Light activity, hazard ratio 0.78 (0.72-0.84; P<0.001), moderate/high-level activity, hazard ratio 0.69 (0.63-0.75; P<0.001). At all levels of blood pressure, the risk of cardiovascular events was significantly reduced independent of the level of physical activity. In conclusion, the association between physical activity and all-cause mortality was present in an inverse dose-response pattern at all levels of blood pressure. Physical activity was associated with reduction in cardiovascular events independent of the level of physical activity.",

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author = "Gowsini Joseph and Marott, {Jacob Louis} and Christian Torp-Pedersen and Tor Biering-Sorensen and Gitte Nielsen and Ann-Eva Christensen and Johansen, {Martin Berg} and Peter Schnohr and Peter Sogaard and Rasmus Mogelvang",

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TY - JOUR

T1 - Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure

AU - Joseph, Gowsini

AU - Marott, Jacob Louis

AU - Torp-Pedersen, Christian

AU - Biering-Sorensen, Tor

AU - Nielsen, Gitte

AU - Christensen, Ann-Eva

AU - Johansen, Martin Berg

AU - Schnohr, Peter

AU - Sogaard, Peter

AU - Mogelvang, Rasmus

PY - 2019/12/1

Y1 - 2019/12/1

N2 - It has been a challenge to verify the dose of exercise that will produce the maximum health benefits in hypertension. This study aimed to explore the association between level of daily physical activity, all-cause mortality and cardiovascular outcome at different blood pressure levels. A random sample of 18 974 white men and women aged 20 to 98 years were examined in a prospective cardiovascular population study. Self-reported activity level in leisure-time was drawn from the Physical Activity Questionnaire (level I: Inactivity; II: Light activity; and III: Moderate/high-level activity). Blood pressure was defined as normal blood pressure: <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 mean follow-up time was 23.4±11.7 years. At all levels of blood pressure, higher levels of physical activity were associated with lower all-cause mortality in a dose-response pattern. The pattern remained unchanged after adjustment for following confounders: Sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index, and calendar time. Compared with inactivity, following hazard ratios were found for stage I hypertension: Light activity, hazard ratio 0.78 (0.72-0.84; P<0.001), moderate/high-level activity, hazard ratio 0.69 (0.63-0.75; P<0.001). At all levels of blood pressure, the risk of cardiovascular events was significantly reduced independent of the level of physical activity. In conclusion, the association between physical activity and all-cause mortality was present in an inverse dose-response pattern at all levels of blood pressure. Physical activity was associated with reduction in cardiovascular events independent of the level of physical activity.

AB - It has been a challenge to verify the dose of exercise that will produce the maximum health benefits in hypertension. This study aimed to explore the association between level of daily physical activity, all-cause mortality and cardiovascular outcome at different blood pressure levels. A random sample of 18 974 white men and women aged 20 to 98 years were examined in a prospective cardiovascular population study. Self-reported activity level in leisure-time was drawn from the Physical Activity Questionnaire (level I: Inactivity; II: Light activity; and III: Moderate/high-level activity). Blood pressure was defined as normal blood pressure: <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 mean follow-up time was 23.4±11.7 years. At all levels of blood pressure, higher levels of physical activity were associated with lower all-cause mortality in a dose-response pattern. The pattern remained unchanged after adjustment for following confounders: Sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index, and calendar time. Compared with inactivity, following hazard ratios were found for stage I hypertension: Light activity, hazard ratio 0.78 (0.72-0.84; P<0.001), moderate/high-level activity, hazard ratio 0.69 (0.63-0.75; P<0.001). At all levels of blood pressure, the risk of cardiovascular events was significantly reduced independent of the level of physical activity. In conclusion, the association between physical activity and all-cause mortality was present in an inverse dose-response pattern at all levels of blood pressure. Physical activity was associated with reduction in cardiovascular events independent of the level of physical activity.

KW - blood pressure

KW - cardiovascular diseases

KW - exercise

KW - hypertension

KW - mortality

KW - physical activity

U2 - 10.1161/hypertensionaha.119.13786

DO - 10.1161/hypertensionaha.119.13786

M3 - Journal article

C2 - 31607173

SN - 0194-911X

VL - 74

SP - 1307

EP - 1315

JO - Hypertension

JF - Hypertension

IS - 6

ER -

Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure

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