Association of subjective and objective physical activity with home hypertension

Prevention of hypertension (HT), a risk factor for cardiovascular diseases, and blood pressure (BP) control are important. For the prevention and management of high BP, increased physical activity (PA) is recommended as a lifestyle intervention. Although various PA assessment methods exist, their associations with clinical BP have been inconsistent. This study aimed to compare self-reported and accelerometer-measured PA in relation to home HT prevalence based on home BP, which has better reproducibility than office BP. We conducted this cross-sectional study of 5895 participants (mean age: 57.5 years, 70.4% women) in the Tohoku Medical Megabank Project Cohort Study. Total PA was assessed using two methods: self-reported activities (leisure, occupational/household) and accelerometer-measured values. Home HT was defined as morning home BP ≥ 135/85 mmHg or under HT treatment. Modified Poisson regression analysis showed no statistically significant association between self-reported total PA and the prevalence of home HT. In contrast, higher levels of accelerometer-measured total PA were associated with lower prevalence of home HT (P for trend <0.05). Regarding other accelerometer-measured components, higher light PA and more steps were also significantly associated with lower prevalence of home HT. These associations were largely mediated by body mass index. In conclusion, accelerometer-measured PA, unlike self-reported PA, was associated with home HT, suggesting that PA assessed by accelerometers is useful for understanding the relationship between PA and HT, preventing HT, and managing high BP.