摘要：Objective. We sought to examine the relation between physical activity and incident hypertension in young adults over 15 years of follow-up in the Coronary Artery Risk Development in Young Adults study. Methods. A total of 3993 Black and White men and women aged 18 to 30 years were examined at baseline, and 2, 5, 7, 10, and 15 years later. Blood pressure and physical activity were measured at each exam. Hypertension was defined as systolic 140 mm Hg or higher, diastolic 90 mm Hg or higher, or antihypertensive medication use. Average physical activity and incident hypertension over 15 years of follow-up were analyzed. Results. There were 634 cases of incident hypertension over 15 years of follow-up. Those who were more versus less physically active experienced a reduced risk (hazard rate ratio = 0.83; 95% confidence interval = 0.73, 0.93) for incident hypertension, after adjustment for race, sex, age, education, and family history of high blood pressure. Conclusions. Physical activity merits attention in the prevention of incident hypertension among young adults, particularly as they move into middle age. Approximately 65 million US adults have high blood pressure. 1 Hypertension is a complex disorder with many genetic and environmental causes. A number of lifestyle factors, such as physical inactivity, contribute to increases in the incidence of hypertension. 2 – 4 In addition to its direct relationship with hypertension, physical inactivity has an indirect association with the development of hypertension through its association with risk factors such as obesity, insulin resistance, and hyperinsulinemia. 5 – 9 In middle-aged and older adults, it is well accepted that physical activity is associated with reduced risk for the development of hypertension. 4 , 10 – 12 It has been observed that aerobic exercise training from 3 to 5 times per week for 30 to 60 minutes per session at moderate intensity lowered blood pressure in both normotensive and hypertensive adults, although the reduction was greater in the hypertensives. 12 Among children and adolescents, no association between physical activity and blood pressure has been observed among normotensives, and small reductions in blood pressure have been noted among hypertensives. 13 , 14 Therefore, the age at which physical activity begins to exert a preventive effect with regard to incident hypertension is not known. Few studies have investigated the association between physical activity and blood pressure in women, Blacks, and young adults. 15 , 16 A study of young adults is particularly important because young adulthood is characterized by important changes in physical activity, weight, and other factors linked with hypertension. We hypothesized that young adults followed for 15 years in the Coronary Artery Risk Development in Young Adults (CARDIA) study who were more physically active would be less likely to experience incident hypertension than would those who were less physically active.
