Making hypertensive inactive patients motivated in exercising

[[abstract]]Introduction: Physical inactivity and hypertension both have high prevalence. Nearly one out of two adults does not have regular physical activity and two out of five have hypertension. Both are known to be major risk factors for all-cause and CVD mortality. But physical activity and hypertension have been separately managed clinically. Clinicians would normally concentrate on treating hypertension, as patients do not see its relevance to physical activity. Objectives: The objective of this study is to express the increased mortality risk from physical inactivity in terms of “blood pressure” so that hypertensive inactive patients are motivated to exercise. Methods: In this prospective cohort study, 416,175 individuals (199 265 men and 216 910 women) went through standard medical screening program(s) from 1996 to 2008, with an average follow up of 8.05 (SD: 4.21) years. All-cause and cardio-vascular disease mortality risks of inactive subjects were compared with active subjects in this cohort. The blood pressure equivalence of physical activity was then identified by the difference in mortality risks between physically inactive and active subjects. Results: Physical inactivity comprised 54% in this cohort, with 22% low active and 24% medium or above active. The prevalence of hypertension was 13%. All-cause and CVD mortality risks for inactive subjects are larger than active subjects at any level of blood pressure. When comparing to active non-hypertensive subjects, the hazard ratios were from 1.06 to 1.72 among active subjects, and hazard ratios were from 1.64 to 2.78 among inactive subjects. The excess mortality risks of physical inactivity were converted into a “blood pressure equivalence of physical activity.” The additional of physical inactive was similar to an increase of mortality risk approximately equivalent to an increase in blood pressure of 50 mmHg. Conclusion: Physical activity in hypertensive patients could provide a reduction of mortality risks similar to a permanent reduction of 50 mmHg in blood pressure, over and above any antihypertensive medications. Appreciating this relationship enables physicians to bridge the disconnection and motivates hypertensive inactive patients to take exercise