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ARTICLE |

Physical Fitness and Incidence of Hypertension in Healthy Normotensive Men and Women FREE

Steven N. Blair, PED; Nancy N. Goodyear, MSPH; Larry W. Gibbons, MD, MPH; Kenneth H. Cooper, MD, MPH
[+] Author Affiliations

Reprint requests to the Institute for Aerobics Research, 12200 Preston Rd, Dallas, TX 75230 (Dr Blair).


JAMA. 1984;252(4):487-490. doi:10.1001/jama.1984.03350040017014
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We measured physical fitness, assessed by maximal treadmill testing in 4,820 men and 1,219 women aged 20 to 65 years. Participants had no history of cardiovascular disease and were normotensive at baseline. We followed up these persons for one to 12 years (median, four years) for the development of hypertension. Multiple logistic risk analysis was used to estimate the independent contribution of physical fitness to risk of becoming hypertensive. After adjustment for sex, age, follow-up interval, baseline blood pressure, and baseline body-mass index, persons with low levels of physical fitness (72% of the group) had a relative risk of 1.52 for the development of hypertension when compared with highly fit persons. Risk of hypertension developing also increased substantially with increased baseline blood pressure.

(JAMA 1984;252:487-490)

REFERENCES

Breslow L, Enstrom JE:  Persistence of health habits and their relationship to mortality . Prev Med 1980;;9:469-483.
Paffenbarger RS, Wing AL, Hyde RT:  Physical activity as an index of heart attack risk in college alumni . Am J Epidemiol 1978;;108:161-175.
Morris JN, Pollard R, Everitt MG, et al:  Vigorous exercise in leisure time: Protection against coronary heart disease . Lancet 1980;; 2:1207-1210.
Peters RK, Cady LD, Bischoff DP, et al:  Physical fitness and subsequent myocardial infarction in healthy workers . JAMA 1983;; 249:3052-3056.
American College of Sports Medicine:  Position statement on the recommended quantity and quality of exercise for developing and maintaining fitness in healthy adults . Med Sci Sports Exerc 1978;;10:VII-X.
Wood PD, Haskell WL, Blair SN, et al:  Increased exercise level and plasma lipoprotein concentrations: A one-year, randomized, controlled study in sedentary middle-aged men . Metabolism 1983;;32:31-39.
Wilmore JH:  Body composition in sport and exercise: Directions for future research . Med Sci Sports Exerc 1983;;15:21-31.
Cooper KH, Pollock ML, Martin RP, et al:  Physical fitness levels vs selected coronary risk factors . JAMA 1976;;236:166-169.
Gibbons LW, Blair SN, Cooper KH, et al:  Association between coronary heart disease risk factors and physical fitness in healthy adult women . Circulation 1983;;67:977-983.
Blair SN, Cooper KH, Gibbons LW, et al:  Changes in coronary heart disease risk factors associated with increased treadmill time in 753 men . Am J Epidemiol 1983;;118:352-359.
Boyer JL, Kasch FW:  Exercise therapy in hypertensive men . JAMA 1970;;211:1668-1671.
Paffenbarger RS, Wing AL, Hyde RT, et al:  Physical activity and incidence of hypertension in college alumni . Am J Epidemiol 1983;; 117:245-257.
Balke B, Ware RW:  An experimental study of physical fitness on Air Force personnel . US Armed Forces Med J 1959;;10:675-688.
Pollock ML, Bohannon RL, Cooper KH, et al:  A comparative analysis of four protocols for maximal treadmill stress testing . Am Heart J 1976;;92:39-46.
Pollock ML, Foster C, Schmidt D, et al:  Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women . Am Heart J 1982;; 103:363-373.
Abraham S, Caroll MD, Najjar MF, et al: Obese and Overweight Adults in the United States , National Health Survey, Series 11, No. (230) . Dept of Health and Human Services publication 83-1680. National Center for Health Statistics, 1983;.
Goodyear NN, Blair SN:  An economical approach to verifying keypunch data , in Proceedings of the Eighth Annual SAS Users Group . Cary, NC, SAS Institute, 1983;, pp 396-401.
Helwig JT, Council KA (eds): SAS User's Guide: 1979 Edition . Raleigh, NC, SAS Institute, 1979;.
Cornfield J:  Joint dependence of risk of coronary heart disease on serum cholesterol and systolic blood pressure: A discriminant function analysis . Fed Proc 1962;;21:58-61.
Cox DR:  Regression model and life tables . J R Stat Soc 1972;;34:187-220.
Roberts J, Rowland M: Hypertension in Adults 25-74 Years of Age , National Health Survey, Series 11, No. (221) . Dept of Health and Human Services publication 81-1671. National Center for Health Statistics, 1981;.
Gillum RF, Taylor HL, Anderson J, et al:  Longitudinal study (32 years) of exercise tolerance, breathing response, blood pressure, and blood lipids in young men . Arteriosclerosis 1981;; 1:455-462.
Blair SN, Ellsworth NM, Haskell WL, et al:  Comparison of nutrient intake in middle-aged men and women runners and controls . Med Sci Sports Exerc 1981;;13:310-315.
Sparrow D, Garvey AJ, Rosner B, et al:  Factors in predicting blood pressure change . Circulation 1982;;65:789-794.
Bjorntorp P:  Hypertension and exercise . Hypertension 1982;;4( (suppl 3) ):III 56-III 59.
Duncan JJ, Hagan RD, Upton J, et al:  The effects of an aerobic exercise program on sympathetic neural activity and blood pressure in mild hypertension , abstracted. Circulation 1983;; 68:285.

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Breslow L, Enstrom JE:  Persistence of health habits and their relationship to mortality . Prev Med 1980;;9:469-483.
Paffenbarger RS, Wing AL, Hyde RT:  Physical activity as an index of heart attack risk in college alumni . Am J Epidemiol 1978;;108:161-175.
Morris JN, Pollard R, Everitt MG, et al:  Vigorous exercise in leisure time: Protection against coronary heart disease . Lancet 1980;; 2:1207-1210.
Peters RK, Cady LD, Bischoff DP, et al:  Physical fitness and subsequent myocardial infarction in healthy workers . JAMA 1983;; 249:3052-3056.
American College of Sports Medicine:  Position statement on the recommended quantity and quality of exercise for developing and maintaining fitness in healthy adults . Med Sci Sports Exerc 1978;;10:VII-X.
Wood PD, Haskell WL, Blair SN, et al:  Increased exercise level and plasma lipoprotein concentrations: A one-year, randomized, controlled study in sedentary middle-aged men . Metabolism 1983;;32:31-39.
Wilmore JH:  Body composition in sport and exercise: Directions for future research . Med Sci Sports Exerc 1983;;15:21-31.
Cooper KH, Pollock ML, Martin RP, et al:  Physical fitness levels vs selected coronary risk factors . JAMA 1976;;236:166-169.
Gibbons LW, Blair SN, Cooper KH, et al:  Association between coronary heart disease risk factors and physical fitness in healthy adult women . Circulation 1983;;67:977-983.
Blair SN, Cooper KH, Gibbons LW, et al:  Changes in coronary heart disease risk factors associated with increased treadmill time in 753 men . Am J Epidemiol 1983;;118:352-359.
Boyer JL, Kasch FW:  Exercise therapy in hypertensive men . JAMA 1970;;211:1668-1671.
Paffenbarger RS, Wing AL, Hyde RT, et al:  Physical activity and incidence of hypertension in college alumni . Am J Epidemiol 1983;; 117:245-257.
Balke B, Ware RW:  An experimental study of physical fitness on Air Force personnel . US Armed Forces Med J 1959;;10:675-688.
Pollock ML, Bohannon RL, Cooper KH, et al:  A comparative analysis of four protocols for maximal treadmill stress testing . Am Heart J 1976;;92:39-46.
Pollock ML, Foster C, Schmidt D, et al:  Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women . Am Heart J 1982;; 103:363-373.
Abraham S, Caroll MD, Najjar MF, et al: Obese and Overweight Adults in the United States , National Health Survey, Series 11, No. (230) . Dept of Health and Human Services publication 83-1680. National Center for Health Statistics, 1983;.
Goodyear NN, Blair SN:  An economical approach to verifying keypunch data , in Proceedings of the Eighth Annual SAS Users Group . Cary, NC, SAS Institute, 1983;, pp 396-401.
Helwig JT, Council KA (eds): SAS User's Guide: 1979 Edition . Raleigh, NC, SAS Institute, 1979;.
Cornfield J:  Joint dependence of risk of coronary heart disease on serum cholesterol and systolic blood pressure: A discriminant function analysis . Fed Proc 1962;;21:58-61.
Cox DR:  Regression model and life tables . J R Stat Soc 1972;;34:187-220.
Roberts J, Rowland M: Hypertension in Adults 25-74 Years of Age , National Health Survey, Series 11, No. (221) . Dept of Health and Human Services publication 81-1671. National Center for Health Statistics, 1981;.
Gillum RF, Taylor HL, Anderson J, et al:  Longitudinal study (32 years) of exercise tolerance, breathing response, blood pressure, and blood lipids in young men . Arteriosclerosis 1981;; 1:455-462.
Blair SN, Ellsworth NM, Haskell WL, et al:  Comparison of nutrient intake in middle-aged men and women runners and controls . Med Sci Sports Exerc 1981;;13:310-315.
Sparrow D, Garvey AJ, Rosner B, et al:  Factors in predicting blood pressure change . Circulation 1982;;65:789-794.
Bjorntorp P:  Hypertension and exercise . Hypertension 1982;;4( (suppl 3) ):III 56-III 59.
Duncan JJ, Hagan RD, Upton J, et al:  The effects of an aerobic exercise program on sympathetic neural activity and blood pressure in mild hypertension , abstracted. Circulation 1983;; 68:285.
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