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 Citations (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.

Original language	English
Journal	Hypertension
Volume	74
Issue number	6
Pages (from-to)	1307-1315
ISSN	0194-911X
DOIs	https://doi.org/10.1161/hypertensionaha.119.13786
Publication status	Published - 1 Dec 2019

Keywords

blood pressure
cardiovascular diseases
exercise
hypertension
mortality
physical activity

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1161/hypertensionaha.119.13786

HYPERTENSIONAHA.119.13786Final published version, 703 KB

https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA.119.13786

Cite this

Joseph, G., Marott, J. L., Torp-Pedersen, C., Biering-Sorensen, T., Nielsen, G., Christensen, A.-E., Johansen, M. B., Schnohr, P., Sogaard, P., & Mogelvang, R. (2019). Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure. Hypertension, 74(6), 1307-1315. https://doi.org/10.1161/hypertensionaha.119.13786

@article{fd7b3c5626934fe199f626975e2ecfaf,

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.",

keywords = "blood pressure, cardiovascular diseases, exercise, hypertension, mortality, physical activity",

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",

year = "2019",

month = dec,

day = "1",

doi = "10.1161/hypertensionaha.119.13786",

language = "English",

volume = "74",

pages = "1307--1315",

journal = "Hypertension",

issn = "0194-911X",

publisher = "Lippincott Williams & Wilkins",

number = "6",

}

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

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this