NEW YORK, June 15: When it comes to exercising for heart health, staying active into middle age is crucial. Research indicates that maintaining consistent physical activity throughout adulthood can help protect against high blood pressure in later years.

A study involving over 5,000 participants from four U.S. cities suggests that social factors can significantly influence an individual's ability to stay active over time.

“Teenagers and people in their early 20s are often physically active, but these patterns tend to shift as they get older,” explained study author and epidemiologist Kirsten Bibbins-Domingo from the University of California, San Francisco (UCSF), when the findings were published in April 2021 in the American Journal of Preventive Medicine.

While numerous studies have confirmed the role of exercise in lowering blood pressure, this study highlights the importance of maintaining high levels of physical activity in young adulthood — possibly beyond current recommendations — to effectively reduce the risk of hypertension.

Hypertension, or high blood pressure, is a major global health concern that can lead to heart attacks, strokes, and is even considered a risk factor for dementia in old age. According to the World Health Organization, more than one in four men and nearly one in five women are affected by the condition. Yet, many people remain unaware they have it, which is why it is often referred to as the “silent killer.”

Exercise remains one of the key interventions for preventing and managing hypertension, which was the focus of this study. The researchers followed more than 5,100 adults over 30 years, tracking their health through physical assessments and questionnaires related to exercise, smoking habits, and alcohol consumption.

During each health check, participants had their blood pressure measured three times, spaced one minute apart. For analysis, the participants were grouped by race and gender into four categories.

The results showed that physical activity levels declined significantly between the ages of 18 and 40, regardless of gender or race, while rates of hypertension steadily increased in the decades that followed.

This trend underscores the importance of promoting exercise during early adulthood to prevent midlife hypertension. “Nearly half of our young adult participants had insufficient levels of physical activity, which was strongly linked to the development of hypertension,” said lead author Jason Nagata, a UCSF specialist in young adult medicine. “This indicates a need to raise the baseline standard for physical activity.”

The study found that individuals who engaged in five hours of moderate exercise per week — twice the current adult recommendation — were significantly less likely to develop hypertension, particularly if they maintained these activity levels through age 60.

“Meeting at least double the current minimum physical activity guidelines appears to offer greater protection against hypertension than simply achieving the minimum,” the researchers noted in their findings.

However, maintaining regular physical activity can be challenging, especially as people navigate major life transitions. “After high school, opportunities for exercise often decline as individuals move into college, the workforce, or take on family responsibilities. Leisure time becomes increasingly limited,” Nagata said.

The study also revealed stark racial disparities in health outcomes. Physical activity among White participants leveled off around age 40, but continued to decline for Black participants. By age 45, Black women had higher rates of hypertension than White men, while White women had the lowest rates through midlife.

By age 60, hypertension affected 80 to 90 percent of Black men and women in the study, compared with just under 70 percent of White men and about 50 percent of White women.

Although the study did not directly assess social or economic factors, the researchers acknowledged that these influences likely contribute to the disparities. Educational attainment — specifically high school completion — was recorded in the data.

“While Black male youth often participate in sports, factors such as socioeconomic status, neighborhood conditions, and family or work responsibilities may limit their ability to remain active into adulthood,” Nagata concluded.