Physical Activity and Hypertension From Young Adulthood to Middle Age

Nagata, Jason M.; Vittinghoff, Eric; Gabriel, Kelley Pettee; Garber, Andrea K.; Moran, Andrew E.; Rana, Jamal S.; Reis, Jared P.; Bibbins‐Domingo, Kirsten

doi:10.1016/j.amepre.2020.12.018

Cited by 23 publications

(18 citation statements)

References 36 publications

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“…Pooled logistic models were used to estimate the independent associations of the expected MVPA at age 18 and subsequent annual change with onset of metabolic disease, adjusting for potential confounders, including sex, race, family history of diabetes or CVD, years of education, smoking status, alcohol use and BMI (smoking status, alcohol use and BMI were time varying, with the last observation carried forward), which have been adjusted for in prior analyses of physical activity and CVD risk (directed acyclic graphs are shown in online supplemental appendix 1). 17 28 We scaled the estimated MVPA score at age 18 from high to low per 100 EUs, corresponding to 0.45 SDs, for ease of interpretation. We kept annual reduction in total MVPA per 1 EU, corresponding to 0.23 SDs.…”

Section: Methodsmentioning

confidence: 99%

Moderate-to-vigorous intensity physical activity from young adulthood to middle age and metabolic disease: a 30-year population-based cohort study

et al. 2021

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ObjectivesTo determine the association between moderate-to-vigorous intensity physical activity (MVPA) trajectories (course over age and time) through the adult life course and onset of metabolic disease (diabetes and dyslipidaemia).MethodsWe analysed prospective community-based cohort data of 5115 participants in the Coronary Artery Risk Development in Young Adults study, who were black and white men and women aged 18–30 years at baseline (1985–1986) at four urban sites, collected through 30 years of follow-up. Individualised MVPA trajectories were developed for each participant using linear mixed models.ResultsLower estimated MVPA score at age 18 was associated with a 12% (95% CI 6% to 18%) higher odds of incident diabetes, a 4% (95% CI 1% to 7%) higher odds of incident low high-density lipoprotein (HDL) and a 6% (95% CI 2% to 11%) higher odds of incident high triglycerides. Each additional annual 1-unit reduction in the MVPA score was associated with a 6% (95% CI 4% to 9%) higher annual odds of diabetes incidence and a 4% (95% CI 2% to 6%) higher annual odds of high triglyceride incidence. Analysing various MVPA trajectory groups, participants who were in the most active group at age 18 (over 300 min/week), but with sharp declines in midlife, had higher odds of high low-density lipoprotein and low HDL incidence, compared with those in the most active group at age 18 with subsequent gains.ConclusionGiven recent trends in declining MVPA across the life course and associated metabolic disease risk, young adulthood is an important time period for interventions to increase and begin the maintenance of MVPA.

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Section: Methodsmentioning

confidence: 99%

Moderate-to-vigorous intensity physical activity from young adulthood to middle age and metabolic disease: a 30-year population-based cohort study

et al. 2021

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“…Physical activity may improve inflammatory and metabolic factors which could protect from premature CVD [ 23 ]. High levels of physical activity in young and middle adulthood are protective of incident hypertension [ 11 ], which could be particularly implicated in the prevention of stroke events. It is notable that both physical activity level and slope were independently associated with premature heart failure and stroke event onset, even after adjusting for several potential sociodemographic and behavioral confounders.…”

Section: Discussionmentioning

confidence: 99%

“…Age (years), race (Black or White), sex (male or female), smoking status (never, former, or current smoker), alcohol use (mL of alcohol consumed/day), educational attainment (highest grade of school completed), and family history of CVD (yes or no) were reported through questionnaire. Based on previous literature and causal directed acyclic graphs, these variables were considered potential confounders for the association between physical activity and CVD [11,12]. Body mass index (BMI) was calculated based on measured height and weight at each examination.…”

Section: Covariatesmentioning

confidence: 99%

“…Blood pressure (hypertension) and fasting laboratory measures (glucose and cholesterol) were measured at each examination. BMI, hypertension, diabetes, and dyslipidemia were considered potential mediators for the association between physical activity and CVD based on previous literature and directed acyclic graphs [11,12,23].…”

Section: Covariatesmentioning

confidence: 99%

“…However, the optimal dose of physical activity, particularly in young adulthood, to prevent CVD events, remains unknown [9,10]. Furthermore, physical activity disparities by race and sex have been noted in young adulthood and through the adult life course [11,12], but it is unknown if race or sex modifies the effect of physical activity and CVD events.…”

Section: Introductionmentioning

confidence: 99%

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Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study

Vittinghoff

Gabriel

Rana

et al. 2022

Int J Behav Nutr Phys Act

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Background Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60. Methods We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985–2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18–30 years at baseline (1985–1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome. Results Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02–1.28), heart failure (AOR 1.21, 95% CI 1.05–1.38), stroke (AOR 1.20, 95% CI 1.04–1.39), and any CVD (AOR 1.15, 95% CI 1.06–1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02–1.13), stroke (1.06, 95% CI 1.00–1.13), and CVD (1.04, 95% CI 1.01–1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57–0.96) and twice the minimum (AOR 0.55, 95% CI 0.34–0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events. Conclusions Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.

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Nonpharmacologic Treatment of Pediatric Hypertension

Daniels

Couch

2023

Pediatric Hypertension

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Physical Activity and Hypertension From Young Adulthood to Middle Age

Cited by 23 publications

References 36 publications

Moderate-to-vigorous intensity physical activity from young adulthood to middle age and metabolic disease: a 30-year population-based cohort study

Moderate-to-vigorous intensity physical activity from young adulthood to middle age and metabolic disease: a 30-year population-based cohort study

Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study

Nonpharmacologic Treatment of Pediatric Hypertension

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