Background: Few prospective studies have simultaneously investigated the relationship between physical activity, cardiorespiratory fitness (CRF), and the development of hypertension in initially normotensive individuals. In the Aerobics Center Longitudinal Study (ACLS), we examined this association among initially healthy normotensive men.
Methods: Participants were 16,601 men aged 20-82 years who completed a baseline examination during 1970-2002 and were followed for hypertension incidence. Physical activity was self-reported and CRF was quantified from the duration of a maximal treadmill test.
Results: A total of 2,346 men reported hypertension during a mean 18 years of follow-up. Event rates per 10,000 man-years adjusted for age and examination year were 86.2, 76.6, and 66.7 across physical activity groups of sedentary, walker/jogger/runner (WJR), and sport/fitness, respectively, and 89.8, 78.4, and 64.6 for low, middle, and high CRF, respectively (trend P < 0.0001). These associations persisted after further adjustment for body mass index (BMI), smoking, alcohol intake, resting systolic blood pressure, baseline health status, family history of diseases, and survey response patterns.
Conclusion: Both physical activity and CRF are associated with lower risk of developing hypertension in a graded fashion. These findings provide a basis for health professionals to emphasize the importance of participating in regular physical activity to improve fitness for the primary prevention of hypertension in men.