Author(s): HWAN, C.Y., YUNMIN, H., HOYONG, S., JIYEON, Y., DUCK-CHUL, L., YEON SOO, K., Institution: SEOUL NATIONAL UNIVERSITY, Country: KOREA, SOUTH, Abstract-ID: 919

INTRODUCTION:
Hypertension is a well-known risk factor for various cardiovascular diseases (CVD), leading to premature deaths globally. Lifestyle interventions, such as physical activity (PA), can effectively mitigate the risk. While current PA guidelines recommend both aerobic PA and muscle-strengthening activities (MSA), most studies have focused mainly on aerobic PA, leading to uncertainty about the additional health benefits of MSA recommendations for individuals with hypertension. Therefore, this study aims to investigate the mortality risk associated with hypertension and adherence to both PA guidelines.
METHODS:
This study included 34,990 participants from the 2007-2013 Korea National Health and Nutrition Examination Surveys (KNHANES), linked to Cause of Death Statistics through 2019. Participants were categorized into four groups based on current PA guidelines: Neither (aerobic PA < 500 METs-min/wk and MSA < 2 days/wk), Only MSA (aerobic PA < 500 METs-min/wk and MSA >= 2 days/wk), Only aerobic PA (aerobic PA >= 500 METs-min/wk and MSA < 2 days/wk), and Both (aerobic PA >= 500 METs-min/wk and MSA >= 2 days/wk). Cox regression, adjusting for potential confounders, estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations of hypertension and meeting PA guidelines with all-cause and CVD mortality. Stratified analyses assessed whether the relationship between meeting PA guidelines and mortality varied based on hypertension status. Additionally, participants were cross-classified into eight groups to assess the joint association of hypertension status and meeting PA guidelines with mortality, with the reference group being hypertensive participants meeting neither of PA guidelines.
RESULTS:
During 9.2 years of the mean follow-up period, 1,948 participants died from any cause, and 419 from CVD. Hypertension was associated with a higher risk of mortality (HR 1.11, 95% CI, 1.01-1.22 for all-cause; HR 1.40, 95% CI, 1.14-1.73 for CVD) compared to normotensive participants. However, adherence to both aerobic PA and MSA guidelines was associated with a lower risk of mortality (HR 0.72, 95% CI, 0.61-0.85 for all-cause; HR 0.54, 95% CI, 0.36-0.80 for CVD). This association was more pronounced in hypertensive participants, but not apparent in normotensive participants. Joint analysis showed that hypertensive participants meeting both aerobic PA and MSA guidelines consistently had lower mortality risk compared to normotensive participants meeting neither of guidelines. Overall, adherence to both PA guidelines was associated with lower risks of all-cause and CVD mortality, regardless of hypertension status.
CONCLUSION:
The findings of this study indicate that meeting both aerobic PA and MSA guidelines, as recommended by current guidelines, is associated with a significant reduction in the risk of all-cause and CVD mortality, even among hypertensive individuals. These results underscore the importance of not only aerobic PA, but also MSA as public health strategies.