Intensity of physical activity related to incidence of hypertension and all-cause mortality: an epidemiological view.

BACKGROUND: Physical activity, obesity, and other personal characteristics predispose subjects to hypertension and premature mortality. We investigated the quantity and intensity of energy expenditure required to deter hypertension and to prevent premature death.
METHODS: Harvard College alumni had returned questionnaires on their health habits and health status in the l960s, in 1977, and in 1988. We computed incidence rates of hypertension and all cause mortality rates, standardized for age and other confounding variables, according to specific physical activities and other personal characteristics during 1977-1988.
RESULTS: We identified 885 cases of hypertension cases 6390 men during 72 544 man-years, and 2343 deaths among 14 786 men during 165 402 man-years. Moderately vigorous sports play led to a reduced risk of hypertension, but walking, stair climbing, and light sports play did not alter that risk. Being overweight, parental hypertension, alcohol consumption, and cigarette smoking increased the risk of hypertension. A combination of these characteristics accounted for one-quarter to one-half of the cases among alumni. Both beginning moderately vigorous sports play and losing weight between the l960s and 1977 led to a lower incidence of hypertension. Sedentary living, especially the lack of moderately vigorous recreational activities, early parental mortality, cigarette smoking, hypertension, and preexisting chronic diseases predisposed subjects to premature death.
CONCLUSION: The lack of moderately vigorous sports play, being overweight, and a parental history of hypertension independently increased the risk of developing hypertension, which itself was a strong predictor of premature death. The intensity of effort was more important than the quantity of energy output in deterring hypertension and preventing premature mortality.