Abstract
Background: Physical activity ( PA ) is associated with lower risk, and chronic stress with increased risk of CVD risk factors ( RFs ) such as hypertension ( HTN ) or type 2 diabetes. Little is known about potential interactions between PA and traumatic stress ( TS ) in relation to CVD risk factors. Objective: To assess whether the association of PA with CVD RFs is modified by the presence of traumatic stress ( TS ). Methods: Cross-sectional data from 4,169 adults ages 18-74 in 2008-11, who participated in the HCHS/SOL Sociocultural Ancillary Study and had complete information on key variables, were analyzed using complex survey design methods. TS was assessed by self-reported lifetime exposure to traumatic events; scores were categorized into tertiles based on number of stressors: low=0-1; intermediate=2; high=≥3. PA was assessed by the Global PA Questionnaire and grouped into 4 levels: inactive, low, intermediate, and high activity. CVD RFs included HTN, obesity, diabetes, smoking, and hypercholesterolemia. Multivariate logistic regression was used for analyses. Results: Compared to high PA levels, intermediate PA was significantly associated with HTN, inactivity was associated with obesity, and inactivity and intermediate PA were associated with diabetes ( Table ). Significant interaction between PA with TS was observed for HTN (p<0.001) but not for other CVD RFs. For effect modification by TS, among persons with low TS, intermediate PA was associated with 2.1 times higher odds of HTN vs. high PA levels. Among those with intermediate TS, low PA was associated with 2.3 times higher odds of HTN, and among those with high TS, inactivity was associated with 2.1 times higher odds of HTN vs. high PA levels. Conclusion: A statistical interaction was observed between traumatic stress and physical activity among those with hypertension (but not with other CVD risk factors), and the odds of HTN varied by TS. Further evaluation is needed to determine physical activity recommendations to prevent hypertension among those with traumatic stress.
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