PHYSICAL ACTIVITY AND INCIDENCE OF HYPERTENSION IN COLLEGE ALUMNI

Paffenbarger, R. S., Jr. (Stanford U. School of Medicine, Stanford, CA 94305), A. L. Wing, R. T. Hyde, and D. L. Jung. Physical activity and incidence of hypertension in college alumni. Am J Epidemiol 1983; 117: 245–57. In a study population of 14, 998 Harvard male alumni, 681 hypertensives were first diagnosed during a 6–10-year follow-up beginning 16–50 years after college entrance. The study comprised 105, 662 man-years of observation of these men who had entered college in 1916–1950, and who were followed from 1962 or 1966 to 1972. Presence or absence of a background of collegiate sports did not influence risk of hypertension in this study population, nor did stair-climbing, walking, or light sports play by alumni. But, alumni who did not engage in vigorous sports play were at 35% greater risk of hypertension than those who did, and this relationship held at all ages, 35–74 years. Higher levels of body mass index, weight gain since college, history of parental hypertension, and lack of strenuous exercise independently predicted increased risk of hypertension in alumni. Men 20% or more over ideal weight-for-height were at 78% greater risk than lighter men. Those who had gained 25+ lbs (c. 11.5+ kg) since entering college were at 60% greater risk than those who had gained less. Alumni with a hypertensive parent were at 83% higher risk than men without such parentage. Contemporary vigorous exercise was inversely related to hypertension risk, but chiefly among alumni overweight-for-height. In the clinical sense, attributable risk estimates ranged from 30% to nearly 50% for the alumni characteristics of overweight, weight gain, parental hypertension, and lack of vigorous exercise. In the community sense, attributable risk of these same characteristics ranged 13–26%. To sum up, vigorous exercise is associated with lower hypertension incidence, and, without necessarily altering body weight-for-height, avoids or reduces fat and promotes muscle; obesity, rather than excess weight-for-height, is associated with higher hypertension incidence; hence, vigorous exercise is appropriate for use as an intervention regimen in the prevention of hypertension.