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American Journal of Epidemiology Advance Access originally published online on November 17, 2005
American Journal of Epidemiology 2006 163(2):142-150; doi:10.1093/aje/kwj019
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

Cardiorespiratory Fitness Is an Independent Predictor of Hypertension Incidence among Initially Normotensive Healthy Women

Carolyn E. Barlow, Michael J. LaMonte, Shannon J. FitzGerald, James B. Kampert, Joe L. Perrin and Steven N. Blair

From The Cooper Institute, Dallas, TX

Correspondence to Carolyn E. Barlow, Centers for Integrated Health Research, The Cooper Institute, 12230 Preston Road, Dallas, TX 75230 (e-mail: bwright{at}cooperinst.org).

The authors examined the association between cardiorespiratory fitness and incident hypertension in women who were normotensive and free of cardiovascular disease at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas), 1970–1998. A total of 4,884 women performed a maximal treadmill exercise test and completed a follow-up health survey. During an average follow-up of 5 years, 157 incident cases of self-reported, physician-diagnosed hypertension were identified from the health surveys. The cumulative incidence of hypertension was 3.2%. Compared with the rates of low-fit women, crude hypertension rates were 60% and 79% lower among women in the moderate and high fitness categories, respectively (p < 0.001). After adjustment for several potential confounders, the odds ratios for hypertension were 1.0, 0.61 (95% confidence interval (CI): 0.30, 1.21), and 0.35 (95% CI: 0.17, 0.73) in low-, moderately, and highly fit women, respectively (ptrend < 0.01). Each 1-metabolic equivalent increment in treadmill performance was, on average, associated with a 19% (95% CI: 10, 27; p < 0.001) lower odds of incident hypertension. The pattern and strength of association between fitness and hypertension persisted in analyses stratified on body mass index, age, and the presence of prehypertension at baseline. An active lifestyle should be promoted for the primary prevention of hypertension in women.

cohort studies; hypertension; motor activity; physical fitness; women

Abbreviations: CI, confidence interval; MET, metabolic equivalent; PAR, population attributable risk


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