Article Title



Zachary S. Leicht1, Nathan R. Weeldreyer1, Marc A. Adams2, Siddhartha S. Angadi, FACSM1. 1University of Virginia, Charlottesville, VA. 2Arizona State University, Phoenix, AZ.

Background: Blood pressure and peak oxygen uptake (VO2peak) are strong independent predictors of all-cause and cardiovascular mortality. Individuals with a VO2peak of 8 METs or greater have decreased risk of cardiovascular disease compared to those with a VO2peak less than 8 METs. Increasing physical activity in insufficiently active adults is associated with improvements in both cardiorespiratory fitness (CRF) and blood pressure (BP), however approximately 90% of adults in the United States do not meet current physical activity guidelines. Additionally, the relationship between CRF and the odds of having an elevated blood pressure (SBP ≥ 120 and/or DBP ≥ 80) or hypertension (SBP ≥ 140 and/or DBP ≥ 90) are unknown. Therefore, we determined the odds of having elevated blood pressure or hypertension in individuals stratified based on VO2peak (< 8METS or ≥ 8 METS). Methods: Insufficiently active (as determined by accelerometry) individuals (N=518) underwent blood pressure and anthropometric testing followed by a treadmill-based graded exercise test (modified Balke protocol) with ventilatory gas exchange assessment to determine VO2peak. Only valid VO2peak tests (defined as achieving ≥90% age-predicted heart rate max and RER > 1.05) were used for analyses. Adjusted Logistic Regression examined the role of CRF in whether subjects would have normal (SBP < 120 and DBP < 80) , elevated BP or hypertension. Data are presented as means ± SD or odds ratios with α was set at 0.05. Results: Three hundred and seventy five individuals had BP measured and met the criteria for a valid VO2peak test (age = 44.8 ± 9.1 years; BMI = 32.9 ± 6.6; VO2peak = 24.5 ± 4.8 mL/kg/min; SBP = 121 ± 13; DBP = 81 ± 10 mmHg; Males/Females = 124/251). One-hundred and twenty-seven individuals had normal BP, 164 had elevated BP, and 84 individuals were hypertensive. After adjusting for age and sex, those with a VO2peak less than 8 METs did not have significantly different odds of having elevated BP (OR = 1.3, 95% CI: 0.7 - 2.4, p = 0.33). However, those with a VO2peak less than 8 METs were more likely to be hypertensive compared to individuals with a VO2peak greater than 8 METs (OR = 2.5, 95% CI: 1.2 - 5.2, p = 0.01). Conclusions: Approximately 33.9% of our cohort had a BP that was in the normotensive range, 43.7% had elevated BP, and 22.4% were hypertensive. Importantly, the present study found that low CRF in inactive adults was associated with an increased odds of being hypertensive. This underscores the high CVD burden in this population and the need for targeted interventions to optimize outcomes. Supported by R01CA198915

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