Dose-response associations between leisure-time physical activity and blood pressure control among treated hypertensive adults: A cross-sectional study from NHANES 2007-2018

Introduction: The additive effects of physical activity on antihypertensive drugs are not fully understood. This study aimed to analyze the dose-response associations between leisure-time physical activity (LTPA) and blood pressure (BP) control, inflammation and oxidative stress regulation in treated hypertensive adults.Methods: A total of 8269 treated hypertensive adults were included from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES) of America. Multivariable linear/logistic regression models and subgroup analyses were performed to analyze the associations between LTPA and systolic BP, diastolic BP and the incidence of uncontrolled hypertension. The dose-response associations for LTPA and biomarkers of inflammation and oxidative stress were also investigatedResults: LTPA was inversely associated with systolic BP (p < 0.05) and the incidence of uncontrolled hypertension (p < 0.05). Regarding different doses, LTPA no less than 900 min/week (dose calculated as moderate LTPA, equals 450 min/week vigorous LTPA) was the most effective in reducing the incidence of uncontrolled hypertension (OR = 0.67, 95% CI (0.47, 0.97), p < 0.05). Vigorous-intensity LTPA was better than moderate in terms of achieving BP control. Various doses of LTPA were also inversely associated with inflammation and oxidative stress biomarkers.Conclusion: Our results suggest that moderate LTPA no less than 900 min/week or vigorous LTPA no less than 450 min/week could significantly reduce the risk of uncontrolled hypertension. In addition, physical activity at various doses could improve inflammation and oxidative stress in treated hypertensive adults, thus reducing the risk of hypertension-related complications. This study extends our understanding of the beneficial effects of physical activity on BP control, inflammation and oxidative stress regulation in hypertensive patients. Future research is needed to provide more detailed exercise suggestions for hypertensive patients.