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Walking Volume and Speed Are Inversely Associated With Incidence of Treated Hypertension in Postmenopausal Women

Originally published28 Sep 2020https://doi.org/10.1161/HYPERTENSIONAHA.120.15839Hypertension. 2020;76:1435–1443

    Abstract

    Few studies have evaluated hypertension incidence in relation to walking, which is a common physical activity among adults. We examined the association between walking and hypertension incidence in 83 435 postmenopausal women who at baseline were aged 50 to 79 years, without known hypertension, heart failure, coronary heart disease, or stroke, and reported the ability to walk at least one block without assistance. Walking volume (metabolic equivalent hours per week) and speed (miles per hour) were assessed by questionnaire. Incident physician-diagnosed hypertension treated with medication was ascertained through annual questionnaires. During a mean 11-year follow-up, 38 230 hypertension cases were identified. After adjustment for covariates including nonwalking activities, a significant inverse association with hypertension was observed across categories of baseline walking volume (0 [referent], >0–3.5, 3.6–7.5, and >7.5 metabolic equivalent hours per week), hazard ratio: 1.00 (referent), 0.98, 0.95, 0.89; trend P<0.001. Faster walking speeds (<2, 2–3, 3–4, and >4 miles per hour) also were associated with lower hypertension risk, hazard ratio: 1.00 (referent), 1.07, 0.95, 0.86, 0.79; trend P<0.001. Further adjustment for walking duration (h/wk) had little impact on the association for walking speed (hazard ratio: 1.00 [referent], 1.08, 0.96, 0.86, 0.77; trend P<0.001). Significant inverse associations for walking volume and speed persisted after additional control for baseline blood pressure. Results for time-varying walking were comparable to those for baseline exposures. This study showed that walking at guideline-recommended volumes (>7.5 metabolic equivalent hours per week) and at faster speeds (≥2 miles per hour) is associated with lower hypertension risk in postmenopausal women. Walking should be encouraged as part of hypertension prevention in older adults.

    Footnotes

    *A list of all WHI Investigators is given in the Data Supplement.

    The Data Supplement is available with this article at https://www.ahajournals.org/doi/suppl/10.1161/HYPERTENSIONAHA.120.15839.

    Correspondance to Michael J. LaMonte, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo—SUNY, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214. Email

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    Novelty and Significance

    What Is New?

    • Walking (an understudied exposure) was prospectively evaluated with hypertension risk.

    • Postmenopausal women (an understudied population) were studied exclusively.

    What Is Relevant?

    • Elevated blood pressure is highly prevalent in older women.

    • Lifestyle modifications are cornerstone to hypertension prevention strategies.

    • Walking is an accessible and enjoyable activity in older adults.

    Summary

    Greater walking volume and speed were associated with lower hypertension risk in postmenopausal women. This carries tremendous implications for enhancing hypertension prevention strategies through targeted promotion of walking, the most common recreational activity in later life when the burden of high blood pressure and its clinical consequences is considerable.

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