title: Longitudinal Patterns of Cardiorespiratory Fitness Predict the Development of Hypertension Among Men and Women.
abstract: BACKGROUND
  Most of the existing literature has linked a baseline cardiorespiratory fitness or change between baseline and one follow-up measurement of cardiorespiratory fitness to hypertension. The purpose of the study is to assess the association between longitudinal patterns of cardiorespiratory fitness changes with time and incident hypertension in adult men and women.
  
  
  METHODS
  Participants were aged 20 to 82 years, were free of hypertension during the first 3 examinations, and received at least 4 preventive medical examinations at the Cooper Clinic in Dallas, Texas, from 1971 to 2006. They were classified into 1 of 5 groups based on all of the measured cardiorespiratory fitness values (in metabolic equivalents) during maximal treadmill tests. Logistic regression was used to compute odds ratios and 95% confidence intervals.
  
  
  RESULTS
  Among 4932 participants (13% women), 1954 developed hypertension. After controlling for baseline potential confounders, follow-up duration, and number of follow-up visits, odds ratios (95% confidence intervals) for hypertension were 1.00 for the decreasing group (referent), 0.64 (0.52-0.80) for the increasing group, 0.89 (0.70-1.12) for the bell-shape group, 0.78 (0.62-0.98) for the U-shape group, and 0.83 (0.69-1.00) for the inconsistent group. The general pattern of the association was consistent regardless of participants' baseline cardiorespiratory fitness or body mass index levels.
  
  
  CONCLUSIONS
  An increasing pattern of cardiorespiratory fitness provides the lowest risk of hypertension in this middle-aged relatively healthy population. Identifying specific pattern(s) of cardiorespiratory fitness change may be important for determining associations with comorbidity, such as hypertension.
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia. Electronic address: msui@mailbox.sc.edu.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Sarzynski
authors.affiliation: Department of Kinesiology, College of Human Sciences, Iowa State University, Ames.
authors.forename: Duck-Chul
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Department of Cardiovascular Diseases, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, La.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Cardiology Division, Veterans Affairs Medical Center; Georgetown University, School of Medicine, Washington, DC.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Kokkinos
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Payne
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D000072599:Cardiorespiratory Fitness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: Exercise capacity; High blood pressure; Prevention