A Study On The Association Between Hypertension And Daily Physical Activity In Urban Residents

Background: With the increasing number of people suffering from hypertension,chronic diseases such as hypertension have become a hot issue in the world.There are more and more studies on the correlation between physical activity and hypertension.The purpose of this study was to gradually reveal the correlation between hypertension and physical activity(PA)and other related variables by building a variety of models,especially to explore the effects of different types of physical activity on systolic blood pressure(SBP)and diastolic blood pressure(DBP).Methods: In this study,54,303 people over 16 years of age,including hypertension and non-hypertension,were recruited from the China Health and Nutrition Survey(CHNS)in Beijing and Shanghai from 2011 to 2018.Relevant variables such as height,weight,waist circumference and PA were obtained and calculated respectively.Types of daily physical activity included sleep,sitting,work,housework,transportation and exercise.In order to balance the sample size,the intensity of physical activity was divided into low intensity physical activity,moderate intensity physical activity,high intensity physical activity and very high intensity physical activity according to the statistical method based on the quartile of MET value.Correlation analysis was used to explore the relationship between SBP,DBP and each numerical variable.To explore whether it is a significant variable contributing to hypertension.A simple linear model was used to analyze the relationship between different types of physical activity and SBP and DBP.UMAP clustering was used for supervised classification of data.The influence of covariates on hypertension was analyzed by generalized linear model.The generalized mixed effects model was used to analyze the effects of other variables on hypertension after adding physical activity intensity classification.The variation decomposition method of standardized regression coefficient was used to classify and summarize the model results,interpret them comprehensively and present them visually.Results:(1)Female SBP was significantly correlated with age,hip circumference,waist circumference,height,weight,waist-to-hip ratio,sebum thickness,BMI,sleep and housework related physical activity(P < 0.001).Female SBP was significantly correlated with sitting,traffic and work-related physical activity(P < 0.01).Female SBP was correlated with exercise(P < 0.05),and the variables with extremely significant correlation with female DBP were the same as SBP.DBP was significantly correlated with sedentary,traffic and sports-related physical activity in females(P < 0.01).Male SBP was significantly correlated with age,hip circumference,waist circumference,height,weight,waist-to-hip ratio,sebum thickness,BMI,sedentary,work and housework related physical activity(P < 0.001).DBP was significantly correlated with age,hip circumference,waist circumference,height,body weight,waist-hip ratio,sebum thickness,BMI and sitting(P <0.001).(2)Logistic regression results showed that sleep,stroke and age were the three variables most associated with hypertension,with OR values of 2.80,2.78 and 2.27,respectively(p < 0.001).(3)The results of simple linear regression showed that sleep,sitting,traffic and work related to the type of physical activity were important factors affecting SBP and DBP(p < 0.001).There was no significant effect between SBP and the type of physical activity related to exercise and DBP and the type of physical activity related to housework.(4)The results of generalized linear model showed that stroke had the largest effect value on hypertension.In addition,whether they smoke,whether they live in rural areas and whether education level affected SBP and whether people between41 and 60 years had a significant impact on DBP(p < 0.001).(5)the generalized mixed effect model showed that the fixed effect value on hypertension increased slightly on the basis of controlling other variables.Other significant variables affecting SBP and DBP were similar to the generalized linear model.(6)The variation decomposition results of standardized regression coefficient show that the explanatory rate of significant variables in this paper is 20.2 % for SBP model and 14 % for DBP model.Living habits,physical activity,personal situation,basic form and physical indicators are all important factors affecting hypertension.The results of SBP model showed basic form > living habits >personal situation > physical indicators > physical activity.The results of DBP model showed living habits > basic form > body indexes > personal situation > physical activity.Conclusion:(1)SBP and DBP were positively correlated with age,body weight,waist circumference,hip circumference,sebum thickness and waist-hip ratio of urban residents.(2)The risk factors for hypertension are related to diabetes,alcohol consumption,stroke,smoking,rural residence and work,including age,height,waist circumference and BMI,and sleep.The protective factors of hypertension are related to lean,age between 41 and 60 years,technical school education,university education,and affected by weight,waist-to-hip ratio and transportation physical activity.(3)Among physical activity types,sleep and housework were significant variables affecting SBP,while exercise,work and transportation were significant variables affecting DBP.(4)When other covariates were considered,stroke,smoking and living in rural areas had the greatest effect on SBP,while stroke,diabetes and age between 41 and 60 had the greatest effect on DBP.There was no significant difference in the effect of physical activity classification on SBP and DBP.(5)All the variables contained in the five types were significant factors affecting hypertension.Although physical activity accounted for a small percentage of the total model,it also had significant significance for SBP and DBP.