Is There a Relationship Between Physical Activity in Free Time and the Incidence of High Blood Pressure?

Keywords
Cardiovascular Diseases; Exercise; Hypertension

Cardiovascular diseases (CVDs) are a group of diseases linked to blood vessels, the heart, and adjacent tissues that impact health and normal life, and it is a disease that has one of the highest morbidity and mortality rates in the world.¹,² In 2019, the biggest cause of death in the world was CVDs, responsible for 16% of total deaths.² In the same year, there were a total of 8.9 million deaths around the world.²

CVDs are the main cause of death, hospitalizations, and outpatient care throughout the world, including in developing countries such as Brazil.¹,³ Just like CVDs, arterial hypertension (AH) is the main risk factor for morbidity, mortality, and disability due to CVDs.¹

AH is a chronic non-communicable disease defined by blood pressure levels that categorize it, as well as a multifactorial condition, which depends on genetic, epigenetic, environmental, and social factors, physiologically characterized by persistent elevation of blood pressure (BP).¹ It can be preventable or delayed by a set of preventive interventions, including reducing salt intake, a diet rich in fruits and vegetables, and physical exercise.⁴ Previous studies have suggested that physical activity in free time (PAFT), was inversely associated with the risk of AH.³,⁴ Thus, PAFT has been recommended as a preventive lifestyle for AH.³

Therefore, in this edition of the Arquivos Brasileiros de Cardiologia, Souza et al.,⁵ investigated longitudinally, the association between changes in PAFT and the incidence of AH in participants of the ELSA-Brazil (Longitudinal Study of Adult Health). ELSA-Brazil is a large multicenter cohort study, which focuses on investigating the incidence and progression of obesity, diabetes, and CVD, in Brazilian adults aged between 35 and 74 years.⁶,⁷

The study analyzed data from 8,968 participants, 4916 women, and 4052 men, in two different periods: from baseline (2008-2010) and followed until the first segment (2012-2014).⁸ Individuals with normal BP (normotensive) were selected and anyone diagnosed with AH or who was taking medication to treat AH was excluded. All participants answered the questionnaires on assessment of PAFT (International Physical Activity Questionnaire -IPAQ- long version), which is composed of questions relating to the frequency and duration of physical activities (walking - moderate and vigorous) carried out at work while commuting, in domestic activities and in free time.⁹

As a result, Souza et al.,⁵ identified that the incidence of AH in the first segment was 16.9%, 12.8% among women, and 21.9% among men, also indicating a statistical association between PAFT and AH in very active participants: risk of AH reduced by 35 % among men RR = 0.65 (95% IC 0.50-0.86) and risk of AH reduced by 66% among women RR = 0.34 (95% IC 0.20-0.58).

With all this, the authors in the discussion associate PAFT, the very physically active group, with a lower risk of developing hypertension over time. Furthermore, women had an even more pronounced reduction in risk compared to men. However, this does not mean that moderate PA is ineffective in preventing AH,⁸ as performing PAFT with moderate to vigorous intensity has already been shown to be efficient in preventing conditions such as CVD and even diabetes.

The results of this study highlight the crucial role of PAFT in reducing the risk of AH, especially when practiced consistently. These findings highlight the importance of promoting an active lifestyle as a preventive measure against AH regardless of gender.¹⁰,¹¹

• Short Editorial related to the article: Leisure Time Physical Activity and Incidence of Arterial Hypertension in ELSA-Brasil Participants

Referências

• ¹
  Pan American Health Organization. Technical Advisory Group on Cardiovascular Disease Prevention Through Dietary Salt/Sodium Reduction: Final Report Phase 3. Geneva: World Health Organization; 2024.
• ²
  World Health Organization. The top 10 Causes of Death [Internet]. Geneva: World Health Organization; 2020 [cited 2024 May 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  » https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
• ³
  Liu X, Zhang D, Liu Y, Sun X, Han C, Wang B, et al. Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies. Hypertension. 2017;69(5):813-20. doi: 10.1161/HYPERTENSIONAHA.116.08994.
  » https://doi.org/10.1161/HYPERTENSIONAHA.116.08994
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  Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM, et al. Brazilian Guidelines of Hypertension - 2020. Arq Bras Cardiol. 2021;116(3):516-658. doi: 10.36660/abc.20201238.
  » https://doi.org/10.36660/abc.20201238
• ⁵
  Souza TC, Matos SMA, Almeida MCC, Fonseca MJM, Molina MDCB, Griep RH, et al. Atividade Física no Tempo Livre e Incidência de Hipertensão Arterial em Participantes do ELSA-Brasil. Arq Bras Cardiol. 2024; 121(6):e20230734. doi: https://doi.org/10.36660/abc.20230734
  » https://doi.org/10.36660/abc.20230734
• ⁶
  Schmidt MI, Griep RH, Passos VM, Luft VC, Goulart AC, Menezes GM, et al. Estratégias e Desenvolvimento de Garantia e Controle de Qualidade no ELSA-Brasil. Rev Saude Publica. 2013;47(Suppl 2):105-12. doi: 10.1590/s0034-8910.2013047003889.
  » https://doi.org/10.1590/s0034-8910.2013047003889
• ⁷
  Aquino EM, Barreto SM, Bensenor IM, Carvalho MS, Chor D, Duncan BB, et al. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Objectives and Design. Am J Epidemiol. 2012;175(4):315-24. doi: 10.1093/aje/kwr294.
  » https://doi.org/10.1093/aje/kwr294
• ⁸
  Pitanga FJG, Pitanga CPS, Beck CC. Physical Activity for the Prevention of Cardiometabolic Diseases: How Much is Required?. Curre Res Diabetes & Obes J. 2019;9(4):555766. doi: 10.19080/CRDOJ.2019.09.555766.
  » https://doi.org/10.19080/CRDOJ.2019.09.555766
• ⁹
  Byambasukh O, Snieder H, Corpeleijn E. Relation Between Leisure Time, Commuting, and Occupational Physical Activity With Blood Pressure in 125 402 Adults: The Lifelines Cohort. J Am Heart Assoc. 2020;9(4):e014313. doi: 10.1161/JAHA.119.014313.
  » https://doi.org/10.1161/JAHA.119.014313
• ¹⁰
  Lear SA, Hu W, Rangarajan S, Gasevic D, Leong D, Iqbal R, et al. The Effect of Physical Activity on Mortality and Cardiovascular Disease in 130 000 People from 17 High-income, Middle-income, and Low-income Countries: The PURE Study. Lancet. 2017;390(10113):2643-54. doi: 10.1016/S0140-6736(17)31634-3.
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• ¹¹
  GBD 2016 Causes of Death Collaborators. Global, Regional, and National Age-sex Specific Mortality for 264 Causes of Death, 1980-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151-210. doi: 10.1016/S0140-6736(17)32152-9.
  » https://doi.org/10.1016/S0140-6736(17)32152-9

Publication Dates

• Publication in this collection
  19 Aug 2024
• Date of issue
  2024

History

• Received
  08 May 2024
• Reviewed
  04 June 2024
• Accepted
  04 June 2024