Blodgett Joanna M, Ahmadi Matthew N, Atkin Andrew J, Pulsford Richard M, Rangul Vegar, Chastin Sebastien, Chan Hsiu-Wen, Suorsa Kristin, Bakker Esmée A, Gupta Nidhi, Hettiarachchi Pasan, Johansson Peter J, Sherar Lauren B, Del Pozo Cruz Borja, Koemel Nicholas A, Mishra Gita D, Eijsvogels Thijs M H, Stenholm Sari, Hughes Alun D, Teixeira-Pinto Armando, Ekelund Ulf, Lee I-Min, Holtermann Andreas, Koster Annemarie, Stamatakis Emmanuel, Hamer Mark
Institute of Sport Exercise and Health, Division of Surgery and Interventional Sciences (J.M.B., M.H.), University College London, United Kingdom.
University College London Hospitals, National Institute for Health and Care Research Biomedical Research Centre, United Kingdom (J.M.B., A.D.H., M.H.).
Circulation. 2025 Jan 14;151(2):159-170. doi: 10.1161/CIRCULATIONAHA.124.069820. Epub 2024 Nov 6.
Blood pressure (BP)-lowering effects of structured exercise are well-established. Effects of 24-hour movement behaviors captured in free-living settings have received less attention. This cross-sectional study investigated associations between a 24-hour behavior composition comprising 6 parts (sleeping, sedentary behavior, standing, slow walking, fast walking, and combined exercise-like activity [eg, running and cycling]) and systolic BP (SBP) and diastolic BP (DBP).
Data from thigh-worn accelerometers and BP measurements were collected from 6 cohorts in the Prospective Physical Activity, Sitting and Sleep consortium (ProPASS) (n=14 761; mean±SD, 54.2±9.6 years). Individual participant analysis using compositional data analysis was conducted with adjustments for relevant harmonized covariates. Based on the average sample composition, reallocation plots examined estimated BP reductions through behavioral replacement; the theoretical benefits of optimal (ie, clinically meaningful improvement in SBP [2 mm Hg] or DBP [1 mm Hg]) and minimal (ie, 5-minute reallocation) behavioral replacements were identified.
The average 24-hour composition consisted of sleeping (7.13±1.19 hours), sedentary behavior (10.7±1.9 hours), standing (3.2±1.1 hours), slow walking (1.6±0.6 hours), fast walking (1.1±0.5 hours), and exercise-like activity (16.0±16.3 minutes). More time spent exercising or sleeping, relative to other behaviors, was associated with lower BP. An additional 5 minutes of exercise-like activity was associated with estimated reductions of -0.68 mm Hg (95% CI, -0.15, -1.21) SBP and -0.54 mm Hg (95% CI, -0.19, 0.89) DBP. Clinically meaningful improvements in SBP and DBP were estimated after 20 to 27 minutes and 10 to 15 minutes of reallocation of time in other behaviors into additional exercise. Although more time spent being sedentary was adversely associated with SBP and DBP, there was minimal impact of standing or walking.
Study findings reiterate the importance of exercise for BP control, suggesting that small additional amounts of exercise are associated with lower BP in a free-living setting.
结构化运动降低血压（BP）的效果已得到充分证实。在自由生活环境中捕捉到的24小时运动行为的影响受到的关注较少。这项横断面研究调查了由6部分组成的24小时行为组合（睡眠、久坐行为、站立、慢走、快走和类似运动的活动[如跑步和骑自行车]）与收缩压（SBP）和舒张压（DBP）之间的关联。
从前瞻性身体活动、久坐和睡眠联盟（ProPASS）的6个队列中收集来自大腿佩戴式加速度计的数据和血压测量值（n = 14761；平均±标准差，54.2±9.6岁）。使用成分数据分析进行个体参与者分析，并对相关的协调协变量进行调整。基于平均样本组成，重新分配图通过行为替代检查估计的血压降低；确定了最佳（即SBP[2 mmHg]或DBP[1 mmHg]临床上有意义的改善）和最小（即5分钟重新分配）行为替代的理论益处。
平均24小时组成包括睡眠（7.13±1.19小时）、久坐行为（10.7±1.9小时）、站立（3.2±1.1小时）、慢走（1.6±0.6小时）、快走（1.1±0.5小时）和类似运动的活动（16.0±16.3分钟）。与其他行为相比，花更多时间锻炼或睡眠与较低的血压相关。额外5分钟的类似运动的活动与估计的SBP降低-0.68 mmHg（95%CI，-0.15，-1.21）和DBP降低-0.54 mmHg（95%CI，-0.19，0.89）相关。在将其他行为的时间重新分配到额外锻炼20至27分钟和10至15分钟后，估计SBP和DBP有临床上有意义的改善。虽然花更多时间久坐与SBP和DBP呈负相关，但站立或行走的影响最小。
研究结果重申了运动对血压控制的重要性，表明在自由生活环境中，少量额外的运动与较低的血压相关。
