Abstract
BackgroundWhen studied in community-based samples, the association of physical activity with blood pressure (BP) remains controversial and is perhaps dependent on the intensity of physical activity. Prior studies have not explored the association of smartwatch-measured physical activity with home BP.ObjectiveWe aimed to study the association of habitual physical activity with home BP.MethodsConsenting electronic Framingham Heart Study (eFHS) participants were provided with a study smartwatch (Apple Watch Series 0) and Bluetooth-enabled home BP cuff. Participants were instructed to wear the watch daily and transmit BP values weekly. We measured habitual physical activity as the average daily step count determined by the smartwatch. We estimated the cross-sectional association between physical activity and average home BP using linear mixed effects models adjusting for age, sex, wear time, antihypertensive drug use, and familial structure.ResultsWe studied 660 eFHS participants (mean age 53 years, SD 9 years; 387 [58.6%] women; 602 [91.2%] White) who wore the smartwatch 5 or more hours per day for 30 or more days and transmitted three or more BP readings. The mean daily step count was 7595 (SD 2718). The mean home systolic and diastolic BP (mmHg) were 122 (SD 12) and 76 (SD 8). Every 1000 increase in the step count was associated with a 0.49 mmHg lower home systolic BP (P=.004) and 0.36 mmHg lower home diastolic BP (P=.003). The association, however, was attenuated and became statistically nonsignificant with further adjustment for BMI.ConclusionsIn this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP. Differences in BMI among study participants accounted for the majority of the observed association.
Highlights
Understanding the relationship between physical activity and blood pressure (BP) is crucial because promoting physical activity might help address the community burden of hypertension
In this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP
In Multimedia Appendix 1, we have presented the baseline characteristics of the study participants including all research center exam attendees and electronic Framingham Heart Study (eFHS) cohort participants
Summary
Understanding the relationship between physical activity and blood pressure (BP) is crucial because promoting physical activity might help address the community burden of hypertension. Several observational and interventional studies have explored the association between physical activity and BP. Data from community-based observational studies suggest that higher self-reported moderate to vigorous physical activity, but not overall physical activity, is associated with lower research center/in-office BP and lower prevalence of incident hypertension [1,2,3,4,5,6]. In interventional studies, promoting moderate to vigorous physical activity leads to a consistent reduction in BP in both normotensive and hypertensive individuals [7,8]. Prior studies have not explored the association of smartwatch-measured physical activity with home BP
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