The impact of physical activity variability with the risk of hypertension: Insights from a national longitudinal study

This study evaluates the relationship between physical activity (PA) variability (PAVar) and the risk of hypertension in middle-aged and older adults. This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study, spanning from 2011 to 2020. A total of 4870 participants with complete PA data were categorized into quartiles based on the coefficient of variation for PAVar. Hypertension incidence was assessed through self-reported physician diagnosis, blood pressure measurements, and antihypertensive medication use. Cox proportional hazards models, adjusted for demographic, socioeconomic, and lifestyle factors, were employed to estimate hazard ratios. Mediation analysis examined the potential role of sleep duration in the PAVar-hypertension relationship, and sensitivity analyses excluded participants with missing baseline data to ensure robustness. Higher PAVar was associated with increased hypertension risk. In fully adjusted models, participants in the highest coefficient of variation quartile had a 75% higher risk of hypertension (HR: 1.75, 95% CI: 1.57-1.95) compared to the lowest quartile. Sleep duration mediated 26.3% of the total effect of PAVar on hypertension risk. Sensitivity analyses confirmed the stability of these findings. This study identifies a significant association between high PAVar and elevated hypertension risk, emphasizing the importance of consistent PA and adequate sleep for hypertension prevention. These findings provide evidence to support tailored public health strategies for hypertension management in aging populations.