Effect of total, domain-specific, and intensity-specific physical activity on all-cause and cardiovascular mortality among hypertensive adults in China

OBJECTIVES: We aimed to prospectively examine the associations of total, domain-specific, and intensity-specific physical activity with all-cause and cardiovascular mortality among Chinese hypertensive adults. METHODS: We performed a prospective cohort study in 150 391 hypertensive participants aged 30–79 years from the China Kadoorie Biobank study of 512 891 participants recruited from 10 diverse areas across China during 2004–2008. Participants with heart disease, stroke, chronic obstructive pulmonary disease, and cancer at baseline were excluded. RESULTS: During 1069 863 person-years of follow-up (median 7.1 years), a total of 5332 men and 4384 women died. Compared with hypertensive participants in the lowest level of total physical activity, the hazard ratios for all-cause mortality were 0.80 (0.76–0.84), 0.69 (0.65–0.73), and 0.67 (0.62–0.72) for those in quartiles 2–4 (P(trend) < 0.001), respectively. Inverse associations were also observed for cardiovascular mortality. Being active in occupational, domestic, and leisure time were associated with lower risk of all-cause and cardiovascular mortality. However, the adjusted ratio for active commuting was 1.08 (1.02–1.15) for all-cause mortality. High levels of low-intensity, moderate-intensity, and vigorous-intensity physical activity were consistently associated with lower risks of all-cause and cardiovascular mortality. CONCLUSION: Among Chinese hypertensive adults, a higher level of physical activity reduces all-cause and cardiovascular mortality, independent of intensities of physical activity. Not only leisure-time but also occupational and domestic physical activities were benefited.