Abstract
AIM: This study aimed to establish robust epidemiological evidence on the association between various dimensions of health-related physical fitness (HRPF) and hypertension among older adults. METHODS: We conducted a large-scale, 7-year cohort study. The baseline survey was conducted in 2015 among participants aged 65 or above from Wuhan, China. Follow-up assessments were integrated into an annual physical examination program for elderly residents in Wuhan, with outcome data collected in 2018, 2019, 2020, 2021, and 2022, respectively. The association between HRPF and hypertension was evaluated using chi-square tests and multivariate Cox regression analyses. RESULTS: Hypertension status was tracked in 695 participants, with an incidence rate of 36.4%. Individuals who developed hypertension showed significantly poorer performance in the chair sit-and-reach (2.60 ± 0.89 VS 2.8 ± 1.13, P = 0.028) and the 30 s arm curl (2.13 ± 1.16 VS 2.26 ± 0.93, P = 0.024), but better performance in back scratch (3.53 ± 1.05 VS 3.74, P = 0.009). Multivariate Cox regression analysis revealed that better performance in the 30-second chair stand test (β:-0.155, HR:0.86, 95%CI: 0.74-0.99, P < 0.05) and back scratch test (β:-0.140, HR:0.87, 95%CI: 0.77-0.97, P < 0.05) was associated with a reduced risk of hypertension, indicating that both are protective factors against the development of hypertension. CONCLUSIONS: Better lower-body muscle strength and upper-body body flexibility appear to be associated with a lower risk of hypertension. Exercise programs targeting these dimensions are recommended to reduce the incidence of hypertension among older adult.