Effects of cardiorespiratory fitness on blood pressure trajectory with aging in a cohort of healthy men

J Am Coll Cardiol. 2014 Sep 23;64(12):1245-1253. doi: 10.1016/j.jacc.2014.06.1184.


Background: Although the trajectory of blood pressure (BP) with aging is well known, there is a lack of data on how cardiorespiratory fitness (hereafter referred to as fitness) affects age-associated changes in BP.

Objectives: The objective of the study was to investigate whether fitness alters the aging-BP trajectory.

Methods: A cohort from the Aerobics Center Longitudinal Study totaling 13,953 men between 20 and 90 years of age who did not have hypertension, cardiovascular disease, or cancer completed 3 to 28 (mean of 3.8) follow-up medical examinations between 1970 and 2006. Fitness was measured by a maximal treadmill exercise test. Longitudinal data were analyzed using linear mixed models.

Results: Diastolic blood pressure (DBP) tended to increase until nearly 60 years of age, when a decrease was observed. Systolic blood pressure (SBP) tended to increase over all age periods. On multivariate analysis, average SBP increased by 0.30 mm Hg (95% confidence interval: 0.29 to 0.31) with 1-year age increment after adjusting for body fat percent, fitness, resting heart rate, glucose level, triglyceride level, cholesterol level, current smoking, heavy alcohol consumption, and parental history of hypertension. DBP had a yearly increase of 0.14 mm Hg (95% confidence interval: 0.13 to 0.15) before age 60 years. Overall, abnormal SBP (>120 mm Hg) began to occur at approximately 50 years of age and abnormal DBP (>80 mm Hg) began to occur at 60 years of age. Men with higher fitness levels experienced abnormal SBP later than those with low fitness levels.

Conclusions: Our findings underscore the potential modifying effect of fitness on BP trajectory with aging over the male adult life span. Improving fitness levels might extend the normal SBP and DBP ranges, delaying the development of hypertension.

Keywords: aging; blood pressure; cardiorespiratory fitness; cohort study.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Blood Pressure / physiology*
  • Cohort Studies
  • Exercise Test / trends*
  • Follow-Up Studies
  • Health Status*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Physical Fitness / physiology*
  • Young Adult