Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California.
Am J Prev Med. 2021 Jun;60(6):757-765. doi: 10.1016/j.amepre.2020.12.018. Epub 2021 Apr 15.
The optimum physical activity dose to achieve during young adulthood to prevent hypertension using the 2017 American College of Cardiology/American Heart Association guidelines remains undefined. This study aims to determine the association between level and change in physical activity through the adult life course and the onset of hypertension using these 2017 definitions.
In 2020, prospective community-based cohort data of 5,115 Coronary Artery Risk Development in Young Adults study participants were analyzed. The cohort included Black and White men and women aged 18-30 years at baseline (1985-1986) at 4 urban sites, collected through 30 years of follow-up (2015-2016). Individualized physical activity trajectories were developed for each participant using linear mixed models.
Black women reported the lowest physical activity levels from young adulthood through middle age. Lower physical activity score (per 100 units) at age 18 years was associated with 4% (95% CI=1%, 7%, p=0.002) higher odds of hypertension incidence. Each additional 1-unit reduction per year in physical activity score was associated with 2% (95% CI=1%, 3%, p=0.001) higher annual odds of hypertension incidence. Meeting approximately the current minimum physical activity guideline levels at age 18 years and through follow-up was not protective of hypertension incidence; however, meeting approximately twice the current minimum physical activity guideline level at age 18 years and through follow-up was protective of hypertension incidence.
Moderate physical activity levels may need to exceed current minimum guidelines to prevent hypertension onset using 2017 American College of Cardiology/American Heart Association definitions.
根据 2017 年美国心脏病学会/美国心脏协会指南，年轻人达到最佳体力活动剂量以预防高血压的最佳剂量仍未确定。本研究旨在使用这些 2017 年的定义，确定整个成年期体力活动水平和变化与高血压发病之间的关系。
在 2020 年，分析了 5115 名冠状动脉风险发展青年研究参与者的前瞻性社区为基础的队列数据。该队列包括基线时（1985-1986 年）年龄在 18-30 岁的黑人和白人男性和女性，在 4 个城市地点进行，通过 30 年的随访（2015-2016 年）进行收集。使用线性混合模型为每个参与者制定个体化的体力活动轨迹。
黑人女性在整个成年期的体力活动水平最低。18 岁时的体力活动得分（每 100 个单位）降低 1%，与高血压发病的几率增加 4%（95%CI=1%，7%，p=0.002）相关。每年体力活动得分减少 1 个单位，与高血压发病的年几率增加 2%（95%CI=1%，3%，p=0.001）相关。18 岁时达到当前最低体力活动指南水平，并在随访期间保持这一水平，并不利于预防高血压的发生；然而，18 岁时达到当前最低体力活动指南水平的两倍并在随访期间保持这一水平，有利于预防高血压的发生。
根据 2017 年美国心脏病学会/美国心脏协会的定义，要预防高血压的发生，中等体力活动水平可能需要超过目前的最低指南。
