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Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study


Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.

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Final study data is available by written request to the investigators.


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We would like to thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnologico (CNPq), and Fundação de Amparo a Ciência e Tecnologia do Estado de Pernambuco (FACEPE) for the financial support.

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AS, BF, JS, MB, and RT. contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript.

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Correspondence to Rafael M. Tassitano.

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The authors declare no competing interests.

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24 Ethics approval was obtained from Ethical Committee of University of Pernambuco (IRB 25 number: 1.722.850).

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Germano-Soares, A.H., Farah, B.Q., Da Silva, J.F. et al. Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study. J Hum Hypertens 38, 575–579 (2024).

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