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Transportation physical activity and new-onset hypertension: A nationwide cohort study in China

Abstract

The association between transportation physical activity (PA) and the risk of hypertension remains uncertain. We aimed to evaluated the prospective relation of transportation PA and new-onset hypertension among Chinese adults. A total of 9350 adults who were free of hypertension at baseline were enrolled from the China Health and Nutrition Survey (CHNS). Data on transportation PA were obtained by using self-reported questionnaires, and calculated as metabolic equivalent task (MET)-minutes/week. MET-minutes/week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 8.0 years (82,410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a U-shaped association between transportation PA and new-onset hypertension (P values for nonlinearity <0.001). Accordingly, compared with those with moderate transportation PA (213−<394 MET-minutes/week, the second quartile), significantly higher risks of new-onset hypertension were observed not only in participants with transportation PA < 213 MET-minutes/week (the first quartile) (HR, 1.29; 95%CI: 1.15–1.44), but in those with transportation PA ≥ 394 MET-minutes/ week (the 3–4 quartiles) (HR, 1.15; 95%CI: 1.04–1.27). Similar U-shaped correlations were found for various types of transportation PA (walking, bicycling, and motorized PA) and new-onset hypertension. In summary, moderate transportation PA is associated with a lower risk of new-onset hypertension among Chinese adults.

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Acknowledgements

This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Carolina Population Center (P2C HD050924, T32 HD007168), the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01-HD38700) and the NIH Fogarty International Center (D43 TW009077, D43 TW007709) for financial support for the CHNS data collection and analysis files from 1989 to 2015 and future surveys, and the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009, Chinese National Human Genome Center at Shanghai since 2009, and Beijing Municipal Center for Disease Prevention and Control since 2011.

Funding

The study was supported by the National Natural Science Foundation of China (81973133, 81730019), Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2017J009).

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Study conception and design: XQ, RL; Acquisition of data: XQ, CL; Analysis and interpretation of data: RL, CL, XQ; Drafting of the manuscript: RL, XQ. All authors critically revised the manuscript, gave final approval, and agree to be accountable for all aspects of work ensuring integrity and accuracy.

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Correspondence to Chengzhang Liu or Xianhui Qin.

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Li, R., Zhang, S., Li, Q. et al. Transportation physical activity and new-onset hypertension: A nationwide cohort study in China. Hypertens Res 45, 1430–1440 (2022). https://doi.org/10.1038/s41440-022-00973-6

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  • DOI: https://doi.org/10.1038/s41440-022-00973-6

Keywords

  • Physical activity
  • Transportation physical activity
  • New-onset hypertension
  • China Health and Nutrition Survey

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