Department of Epidemiology.
Department of General Medicine, Nara Medical University School of Medicine.
J Hypertens. 2020 Apr;38(4):649-655. doi: 10.1097/HJH.0000000000002302.
Prognostically, night-time blood pressure (BP) is more important than other BP parameters. Previous physiological studies suggested physical exercise continuously decreases subsequent BP levels, although the association between daytime physical activity and night-time BP has not been evaluated in large populations.
This cross-sectional study of 1111 older adults (mean age, 71.8 years) measured physical activity using actigraphy and ambulatory BP parameters.
The mean night-time SBP and DBP were 115.9 mmHg (SD, 16.2) and 67 mmHg (8.6), respectively, and the mean average daytime physical activity was 299.2 counts/min (104.3). A multivariable linear regression analysis, adjusted for potential confounders, suggested greater average daytime physical activity was significantly associated with lower night-time SBP (regression coefficient per 100 counts/min increment, -1.18; 95% CI -2.10 to -0.26), and DBP (-0.69; 95% CI -1.17 to -0.17). Significant associations between time above activity thresholds and night-time SBP were consistently observed (≥500 counts/min: regression coefficient per log min increment, -1.61, 95% CI -3.14 to -0.08; ≥1000 counts/min: -1.00, 95% CI -1.97 to -0.03; ≥1500 counts/min: -1.13, 95% CI -2.11 to -0.14). A subgroup analysis without antihypertensive medications (n = 619) strongly associated time above activity thresholds with night-time SBP (≥500 counts/min: -2.94; 95% CI -5.20 to -0.68). These results were consistent in the analysis using dipping as a dependent variable.
Objectively measured daytime physical activity was significantly and inversely associated with night-time BP in older adults. Further longitudinal studies would ascertain effects of physical activity on night-time BP.
从预测角度来看，夜间血压比其他血压参数更为重要。此前的生理学研究表明，体力活动会持续降低随后的血压水平，尽管尚未在大人群中评估日间体力活动与夜间血压之间的关系。
本研究纳入了 1111 名老年人（平均年龄 71.8 岁），通过活动记录仪测量体力活动，并使用动态血压监测仪测量血压参数。
夜间收缩压和舒张压的平均值分别为 115.9mmHg（标准差 16.2mmHg）和 67mmHg（标准差 8.6mmHg），平均日间平均体力活动为 299.2 计数/分钟（104.3）。多变量线性回归分析，调整了潜在混杂因素，表明日间平均体力活动较高与夜间收缩压（每增加 100 计数/分钟的回归系数，-1.18；95%置信区间-2.10 至-0.26）和舒张压（-0.69；95%置信区间-1.17 至-0.17）降低显著相关。观察到时间超过活动阈值与夜间收缩压之间存在一致的显著关联（≥500 计数/分钟：每增加一个对数分钟的回归系数，-1.61；95%置信区间-3.14 至-0.08；≥1000 计数/分钟：-1.00；95%置信区间-1.97 至-0.03；≥1500 计数/分钟：-1.13；95%置信区间-2.11 至-0.14）。没有服用降压药物的亚组分析（n=619）强烈表明时间超过活动阈值与夜间收缩压显著相关（≥500 计数/分钟：-2.94；95%置信区间-5.20 至-0.68）。这些结果在使用夜间血压下降作为因变量的分析中是一致的。
在老年人中，客观测量的日间体力活动与夜间血压呈显著负相关。进一步的纵向研究将确定体力活动对夜间血压的影响。
