Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 19, 2023
Open Peer Review Period: Jun 19, 2023 - Aug 14, 2023
Date Accepted: Jun 7, 2024
(closed for review but you can still tweet)
Association of wearable devices-measured step volume and variability with blood pressure in Chinese older adults: mobile-based longitudinal observational study
ABSTRACT
Background:
The paucity of evidence on longitudinal and uninterrupted recording of physical activity (PA) and blood pressure (BP) under real-life conditions and their relationships, is a vital research gap that needs to be addressed.
Objective:
This study aimed to examine the associations between device-assessed PA (step volume and variability) and BP in older adults.
Methods:
This population-based cohort involved 3070 community-dwelling older adults. Daily step counts were assessed using wearable devices and were managed within a remote mobile management system. Consecutive PA recordings which are 0-6 days prior to each BP measurement were extracted for analyses. We derived the standard deviation (SD) of the daily step volume to estimate step variability. Generalized estimation equation models were used to estimate the individual and joint associations between daily step volume and variability with blood pressure.
Results:
Higher levels of daily step volume were associated with lower blood pressure (SBP, DBP, MAP and PP). Compared with individuals who had a low daily step volume in a week, those who took high steps had the greatest decrease in SBP (-0.913 mmHg, 95% CI -1.27 to -0.556), while the medium step group was associated with the strongest decrease in DBP (-0.5 mmHg, 95% CI -0.721 to -0.279). Stronger protective effects were found in participants with regular step volume. Subgroup analyses indicated generally greater effects on individuals who were female, normotensive and with a chronic disease, but the pattern of effects was mixed and heterogeneous.
Conclusions:
Higher step volume had an important protective effect on blood pressure in older adults with chronic conditions. Regular steps enhanced the beneficial effects of step volume on blood pressure, suggesting likely synergistic effects. For participants with hypertension and with more chronic disease burden, physical activity interventions combining both step volume and variability can result in more benefits in controlling blood pressure.
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