Hypertension and physical activity

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Physical Activity: The Best Prescription for Hypertension
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Lifestyle adjustments, including physical activity and exercise, are the standard first-line treatments for hypertension 6. It is well known that favorable physiological changes and overall health benefits are associated with regular physical activity 7. Together with evidence from observational and clinical studies, appropriate levels of physical activity may reduce the occurrence of hypertension through complex biological pathways 6 , 7 , 8 , 9.

Although several investigators have evaluated influences of physical activity on hypertension prevention, few have assessed the optimal duration for how long , frequency how often , volume how much in total and intensity how hard of doing physical activity, that would lead to lower or normal blood pressure among middle-aged and older adults.


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To fill this gap in knowledge, we completed a cross-sectional study to evaluate the relation between levels of physical activity and hypertension. The second important independent variable was vigorous activity over half an hour one day normalized importance: The detailed rank of the importance of physical activity levels on prevention of hypertension can be found in Fig.

The structure of the decision tree model.

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Red categories indicate the prevalence of hypertension and blue categories indicate the prevalence of no hypertension. In this nationally representative longitudinal survey of middle-aged and older adults in China, the adjusted prevalence of hypertension was The new hypertension guidelines with lower threshold and blood pressure targets are consistent with the World Hypertension League WHL global health goals with a focus on population-based risk reduction with the lowering of blood pressure 1 , Assuming the new hypertension guidelines are adopted in China, the high prevalence and poor control will arouse more urgent attention on hypertension.

So we suggested patients pay more attention to proper physical activity to achieve a normal weight to decrease the rate of hypertension.

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The strength of our study is in using a decision tree which clearly ranks the importance of those key factors affecting hypertension. Clearly, vigorous physical activity was far more effective than moderate or light activity on prevention of hypertension. In addition, days of vigorous or moderate physical activity per week was also important.

For additional health benefits, we recommend that older adults increase their vigorous physical activity to half an hour one day. This recommendation would differ in cases where an older adult cannot take part in any vigorous physical activity. In addition, there are other various types of physical activities for them to choose from. As the node 10 of the decision tree showed, the prevalence of hypertension was Although the decision tree model could not reflect the specific patterns, it could be a helpful reference for undertaking a new fitness regime for hypertension prevention.

It was worth noting that vigorous physical activity would increase the risk of musculoskeletal injury rates. There are several possible factors that could result in the difference. Firstly, it has been well-documented that most rural residents in China had to spend more time on hard manual labor because most of them were self-employed in agriculture-related activities More time doing hard manual labor would reduce the prevalence of hypertension in villagers.

Secondly, risk factors of hypertension such as growing rates of stress, irregular diet, irregular physical activity, smoking, obesity, and pollution were more serious in main city zones than in villages For that reason, public health campaigns and incentives need to be strengthened in main city zones of China.

In this study, The prevalence of hypertension did not present significant gender differences overall: A previous study showed that the prevalence of hypertension was higher among males until the age of 45, nearly equal between the two genders from 45 to 64 years old, and after that hypertension became more prevalent among women In our study, the interaction of age and gender may be the reason why there was no significant difference in the prevalence of hypertension between two genders.

Further studies will be needed to confirm the effect of gender on hypertension among Chinese older adults. Our study had several potential limitations. First, the cross-sectional nature of our study provided limited evidence for the causal association between physical activity and hypertension. We simply offer suggestions for physical activity to prevent hypertension according to the observed results. We did not conduct a long-term experiment to identify the number of weeks of exercise required to observe a significant reduction in hypertension.

However, in real life it often lacks the ability to measure attribute values that the traditional method does. Human behavior is much more complicated than the model simulation of the real world, and this conclusion is worthy of clinical application and further research. Third, genetic factors are another important factor associated with hypertension in China. Many related studies had been performed in China and the results showed that human cytochrome P had the most important influence on the development of essential hypertension in China 17 , 18 , However, no consideration was given to this factor in this study because of the lack of genetic information.

The proportion of anti-hypertensive treatment and effectiveness according to the US guidelines might have little significance considering that the anti-hypertensive treatment in was based on the valid national guidelines. However, the present study relates to the guidelines which are not sufficient in China. This study may provide a reference for future research. New research will be required to solve these issues. However, these limitations do not considerably affect our study findings and recommendations for the prevention of hypertension.

All methods of this study were performed in accordance with the relevant guidelines and regulations. Written informed consent was obtained from all study participants. Multi-stage stratified probability-proportional-to-size sampling method was used to draw the sample Demographic characteristics, socioeconomic status, lifestyle behaviors, and health status were collected by face-to-face interviews Data were drawn from the fourth wave of CHARLS which was conducted in released in October , version ID: , consisting of individuals aged 45 years and older from 28 provinces of China who completed assessments of healthy lifestyle behaviors and measurement of hypertension.

The questionnaires were recovered on the spot at the same time. BP was measured by sphygmomanometer 3 times at 5-minute intervals. Physical exercise practice was calculated according to self-reported information through household interviews. The mean of the 3 readings was calculated. Awareness of hypertension was defined by a self-report of a prior diagnosis of hypertension by a doctor.

Treatment of hypertension was defined as the self-reported use of taking Chinese traditional medicine, taking Western modern medicine, or other treatments for the management of hypertension. Light physical activity was defined as walking to travel from place to place, and any other walking that you might do solely for recreation, sport, exercise, or leisure.

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Moderate physical activity was defined as making breath somewhat harder than normal and may include carrying light loads, bicycling at a regular pace, or mopping the floor. Vigorous activity was defined as making breath much harder than normal and may include heavy lifting, digging, plowing, aerobics, fast bicycling, or cycling with a heavy load. Statistical analysis was performed using R 3. There are two sets of cross-section weights released in this wave of CHARLS, one without non-response adjustment, and another with.

Hypertension and physical activity in middle-aged and older adults in China

We used the cross-section weights with non-response adjustment of the participants in this study, and the construction method of this weights is similar to the baseline weights but taking account of the death and divorce The chisq. Logistic regression was used to examine the lifestyle factors related to the development of hypertension, and the glm function in stats package of R was used to fit these models. Decision tree model was used to analyze the normalized importance of different physical activity levels on prevention of hypertension. Rpart R package, version 4.

We used the decision tree model not only for their primary task the decision making , but also for outlining the normalized importance of each independent variable using a well-known property of the decision trees—their knowledge representation. Previous studies had demonstrated that being overweight or obese increased the likelihood of developing hypertension 5 , 24 , In this study, BMI was selected as an influence variable which defines how much influence an individual has on the tree-growing process.

Individuals with lower influence values have less influence; and individuals with higher values have more. Our main interest was to discover the independent variable importance different levels of physical activity on prevention of hypertension. Classification regression tree CART growing method was used to split the data into segments that were as homogeneous as possible with respect to the dependent variable.

The sum of goodness for each split was used to measure of the variable importance in the decision tree model 26 , Whelton, P. Lu, J. Prevalence, awareness, treatment, and control of hypertension in China: data from 1. He, J. Major causes of death among men and women in China. Danaei, G. National, regional, and global trends in systolic blood pressure since systematic analysis of health examination surveys and epidemiological studies with country-years and 5.

Nisanci Kilinc, F. Diet and physical activity interventions do have effects on body composition and metabolic syndrome parameters in overweight and obese adolescents and their mothers.

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Turk J Pediatr 55 , — Bakker, E. Physical activity and fitness for the prevention of hypertension.

Physical activity is crucial to managing high blood pressure, but it must be done wisely.

Keeping a regular schedule with your exercise will provide you more consistent feedback with your exercise progress. Timing your workouts In general, exercising earlier in the day is better than at night. Exercising shortly before bedtime may interfere with sleep, and poor sleep is a risk factor for high blood pressure. Research has also shown that morning workouts can help lower blood pressure immediately, and carry those benefits throughout the day.

As for meals, Crawford suggests waiting about 90 minutes after eating before exercising. Some people can also experience increased symptoms of chest discomfort if they try to exercise right after eating, due to the demand for blood from both the muscles and the gut. That discomfort may also reflect increased GERD symptoms.

Extreme temperatures can contribute to high blood pressure. Crawford also emphasizes the importance of staying hydrated before, during and after you exercise. He adds that for optimal results on blood pressure management, a moderate amount of exercise should be done daily. Exercise classes are strongly recommended, especially because you can learn proper form before trying various exercises on your own. Local senior centers and other facilities often have low-impact aerobics classes and other programs designed for older adults.

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  4. Keeping a record of your workouts can also be helpful as you start to increase the intensity or duration of your exercises. Final thoughts When you exercise, your systolic blood pressure will increase above the resting rate to make sure your working muscles get the blood and oxygen they need. Your diastolic reading may stay the same or go lower than its normal, resting rate.

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