In men with high blood pressure, staying fit may lower their risk of dying from heart disease. This conclusion comes from a 29-year study.
The results of the study are published today in the ESC’s journal European Journal of Preventive Cardiology.
“This was the first study to assess the combined effects of fitness and blood pressure on the risk of death from heart disease,” said study author Professor Jari Laukanen of the University of Eastern Finland, Kuopio, Finland. “The results suggest that staying fit may help protect against some of the negative effects of high blood pressure.”
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About 13 billion people between the ages of 30 and 79 suffer from hypertension or high blood pressure. Globally, hypertension is one of the leading causes of premature death and an important risk factor for heart attack and stroke. Higher levels of cardiorespiratory fitness are associated with longer lifespans, according to previous studies. This study looked at the relationship between blood pressure, fitness and heart attack risk.
The study involved 2,280 men aged 42 to 61 years living in eastern Finland and enrolled in the Kuopio Ischemic Heart Disease Risk Factor Study. Baseline measurements were conducted between 1984 and 1989. These included blood pressure and cardiorespiratory fitness, which was assessed as maximal oxygen consumption during stationary cycling. Blood pressure was classified as normal or high, and fitness was classified as low, moderate, or high.
The mean age at baseline was 53 years. Participants were followed up until 2018. During a median follow-up of 29 years, there were 644 deaths from cardiovascular disease. The risk of death from heart attack was analyzed based on age, body mass index, cholesterol level, smoking status, type 2 diabetes, coronary heart disease, use of antihypertensive drugs, alcohol consumption, physical activity, socioeconomic status and high susceptibility. – Reactive protein (a marker of inflammation).
Considering blood pressure alone, compared with normal values, hypertension was associated with a 39% increased risk of cardiovascular death (hazard ratio [HR] 1.39; 95% confidence interval [CI] 1.17-1.63). When only fitness was considered, compared with high levels, low fitness was associated with a 74% higher odds of cardiovascular death (HR 1.74; 95% CI 1.35–2.23).
To assess the joint associations of blood pressure and fitness with cardiovascular risk, participants were classified into four groups: 1) normal blood pressure and high fitness (this was the reference group for comparison); 2) normal blood pressure and low fitness; 3) high blood pressure and high fitness; 4) High blood pressure and low fitness.
Men with high blood pressure and low fitness had twice the risk of cardiovascular death compared with men with normal blood pressure and high fitness (HR 2.35; 95% CI 1.81–3.04). When men with high blood pressure had high fitness levels, their elevated risk of heart attack persisted but was weaker: it was 55% higher than in men with normal blood pressure and high fitness (HR 1.55; 95% CI 1.16-2.07).
Professor Laukanen said: “Both high blood pressure and low fitness levels were associated with an increased risk of cardiovascular death. Higher fitness levels reduced, but did not eliminate, the risk of cardiovascular death in men with hypertension.”
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