High levels of fitness may lower the risk of mortality from cardiovascular disease in men with high blood pressure, according to a 29-year research that was published in the ESC publication European Journal of Preventive Cardiology.
According to the research’s lead author Professor Jari Laukkanen of the University of Eastern Finland in Kuopio, Finland, “this was the first study to investigate the combined impact of fitness and blood pressure on the risk of dying from cardiovascular disease.” The findings imply that maintaining a healthy weight might help stave off some of high blood pressure’s side effects.
Worldwide, almost 1.3 billion persons between the ages of 30 and 79 have high blood pressure (hypertension).
2 Globally, hypertension is one of the leading causes of premature death and a significant risk factor for heart attacks and strokes. High levels of cardiorespiratory fitness have been associated with longer lifespans, according to previous research. This research looked at the relationship between blood pressure, fitness, and the risk of cardiovascular mortality.
2,280 males who were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and lived in eastern Finland between the ages of 42 and 61 were included in the research. Measurements at the baseline were made between 1984 and 1989. These included blood pressure and cardiorespiratory fitness, which was assessed as maximal oxygen uptake while riding a stationary bicycle. Fitness levels were categorized as low, medium, or high, and blood pressure as normal or high.
At the baseline, the average age was 53. Up until 2018, participants were followed. Throughout the course of a median follow-up of 29 years, 644 fatalities from cardiovascular disease occurred. Age, body mass index, cholesterol levels, smoking status, type 2 diabetes, coronary heart disease, use of antihypertensive medication, alcohol consumption, physical activity, socioeconomic status, and high sensitivity C-reactive protein were all taken into account when analyzing the risk of death from cardiovascular disease (a marker of inflammation).
Regarding blood pressure alone, relative to normal levels, high blood pressure was linked with a 39% higher risk of cardiovascular death (hazard ratio [HR] 1.39; 95% confidence interval [CI] 1.17-1.63). Regarding fitness alone, compared with high levels, poor fitness was related with a 74% higher chance of cardiovascular mortality (HR 1.74; 95% CI 1.35-2.23).
Participants were divided into four groups to investigate the combined correlations between blood pressure and fitness and risk of cardiovascular mortality. 1) a reference group with high fitness levels and normal blood pressure; 2) normal blood pressure and low fitness; 3) high blood pressure and high fitness; 4) high blood pressure and poor fitness.
Compared to men with normal blood pressure and high fitness, those with high blood pressure and low fitness had a risk of dying from cardiovascular causes that was more than double (HR 2.35; 95% CI 1.81-3.04). It was 55% higher than that of men with normal blood pressure and high fitness (HR 1.55; 95% CI 1.16-2.07) when men with high blood pressure also had high levels of fitness.
According to Professor Laukkanen, having high blood pressure and being physically inactive both increase the chance of dying from cardiovascular causes. In males with raised blood pressure, being physically active reduced but did not completely remove the increased risk of cardiovascular death.
The strong, independent, and causative link between blood pressure and cardiovascular disease may in part account for why cardiorespiratory fitness cannot totally remove the risk of cardiovascular mortality in those with high blood pressure.
Professor Laukkanen concluded: “Getting blood pressure under control should remain a goal in those with elevated levels. Our findings reveals that males with high blood pressure should also seek to increase their fitness levels with frequent physical exercise. Avoiding extra body weight in addition to regular exercise may improve fitness.
To lower all-cause mortality, cardiovascular death, and disease, ESC recommendations advise persons of all ages to aim for at least 150 to 300 minutes a week of moderate-intensity or 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equal mix.
