title: Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.
abstract: Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose-response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose-response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose-response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose-response association of PA and hypertension (Pnonlinearity=0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases.
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Dongdong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Xizhuo
authors.initials: X
authors.lastname: Sun
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Chengyi
authors.initials: C
authors.lastname: Han
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Bingyuan
authors.initials: B
authors.lastname: Wang
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Yongcheng
authors.initials: Y
authors.lastname: Ren
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Junmei
authors.initials: J
authors.lastname: Zhou
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.).
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Hu
authors.affiliation: From the Department of Preventive Medicine, Shenzhen University Health Sciences Center, Guangdong, China (X.L., D.Z., C.H., B.W., Y.R., J.Z., Y.Z., D.H., M.Z.); The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Guangdong, China (Y.L., X.S., C.H., B.W., Y.R., J.Z., Y.Z., D.H.); and Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China (C.H., B.W., Y.R., Y.Z., Y.S.). zhangming@szu.edu.cn.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D015444:Exercise / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D012306:Risk
keywords: cohort studies; exercise; hypertension; meta-analysis; risk