Background: There is insufficient evidence to show that the guidelines' recommendations of physical activity (PA) are associated with long-term benefits in individuals with hypertension.
Methods: This prospective cohort study included UK Biobank participants with hypertension. Time spent on vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) measured by wrist-worn accelerometer were extracted. The primary outcomes were major adverse cardiovascular events (including cardiovascular death, stroke, and myocardial infarction) and all-cause mortality. The secondary outcomes were cardiovascular death, myocardial infarction, and stroke, respectively. The relationships of PA with outcomes were analyzed using Cox regression models.
Results: This study included 49 060 eligible participants with a median follow-up of 7.0 years. MPA was inversely associated with risks of major adverse cardiovascular events and all-cause mortality. Modest amounts of LPA or VPA were likely to be more beneficial than higher amounts of either in all-cause death or cardiovascular outcomes. Compared with the least active group, 150 to 300 min/wk of MPA or more was significantly associated with decreased risk of all-cause death (by 34%-54%) and major adverse cardiovascular events (by 23%-41%), but 75 to 150 min/wk of VPA or more was associated with few further benefits, even weakening the cardiovascular benefits.
Conclusions: MPA had an inverse dose-response association with the risk of all-cause mortality and cardiovascular outcomes in individuals with hypertension. Modest amounts of LPA or VPA are also beneficial, but higher amounts may be not. MPA may be the optimal PA intensity for individuals with hypertension. Further researches are required to determine whether high levels of VPA should be recommended.
Keywords: accelerometry; cardiovascular diseases; exercise; hypertension; mortality.