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<p>Recent epidemiological research showed inconsistent evidence linking physical activity (PA) and air pollution to blood pressure (BP) and hypertension, focusing mainly on particulate matter while neglecting other pollutants. This study aimed to investigate the combined effects of PA and various air pollutants on BP and hypertension in a sample of 13,418 adults from different regions in China. To quantify the level of PA, the Metabolic equivalent task (MET) was applied in this study. A generalized linear regression model was utilized to identify independent associations and interactions between air pollution, PA, BP, and hypertension. Additionally, interaction plots were used to visually demonstrate the relationships between air pollution, PA, and the increased hypertension risk. We observed that air pollution has the potential to increase BP and the risk of hypertension, while PA could reduce it. PA can attenuate the adverse impacts of air pollution on hypertension risk. Furthermore, our findings indicate that the beneficial effects of PA in reducing BP and hypertension risk outweigh the detrimental effects of air pollutants when PA levels exceed 336 MET-hour/week (95% CI: 42, 431), 246 MET-hour/week (95% CI: 45, 431), and 347 MET-hour/week (95% CI: 56, 431) for O<sub>3</sub> and SO<sub>2</sub> respectively. In conclusion, our results suggest that PA may serve as an effective strategy to decrease BP and lower the risk of hypertension even in polluted areas.</p> Graphical Abstract <p></p> <p>Based on the graphical snapshot, this large-scale study of 13,418 Chinese adults investigated the interplay between physical activity (PA), air pollution (including O<sub>3</sub> and SO<sub>2</sub> beyond particulate matter), blood pressure (BP), and hypertension. Despite inconsistent prior evidence, our findings demonstrate that regular PA, quantified in MET-hours/week, significantly lowers BP and reduces hypertension risk. Crucially, PA effectively counteracts the adverse cardiovascular effects of air pollution exposure. Using generalized linear regression models, we identified specific thresholds of PA beyond which its protective benefits outweigh the detrimental impacts of pollutants. The turning points were approximately 336 MET-hours/week for overall air pollutants, 246 for O<sub>3</sub>, and 347 for SO<sub>2</sub>. In conclusion, this research underscores that engaging in sufficient levels of PA is a viable public health strategy for mitigating hypertension risk, even in populations exposed to significant air pollution.</p>

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Physical Activity Attenuated Even Reversed the Associations Between Ambient Air Pollutants and Hypertension: A Nationwide Study Among Chinese Adults

  • 期刊论文

  • 发表日期：

    2026年2月20日

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  • Yun Li,
  • Qian Guo,
  • Yuchen Zhao,
  • Mengyao Bian,
  • Jiahao Zhao

摘要

Recent epidemiological research showed inconsistent evidence linking physical activity (PA) and air pollution to blood pressure (BP) and hypertension, focusing mainly on particulate matter while neglecting other pollutants. This study aimed to investigate the combined effects of PA and various air pollutants on BP and hypertension in a sample of 13,418 adults from different regions in China. To quantify the level of PA, the Metabolic equivalent task (MET) was applied in this study. A generalized linear regression model was utilized to identify independent associations and interactions between air pollution, PA, BP, and hypertension. Additionally, interaction plots were used to visually demonstrate the relationships between air pollution, PA, and the increased hypertension risk. We observed that air pollution has the potential to increase BP and the risk of hypertension, while PA could reduce it. PA can attenuate the adverse impacts of air pollution on hypertension risk. Furthermore, our findings indicate that the beneficial effects of PA in reducing BP and hypertension risk outweigh the detrimental effects of air pollutants when PA levels exceed 336 MET-hour/week (95% CI: 42, 431), 246 MET-hour/week (95% CI: 45, 431), and 347 MET-hour/week (95% CI: 56, 431) for O3 and SO2 respectively. In conclusion, our results suggest that PA may serve as an effective strategy to decrease BP and lower the risk of hypertension even in polluted areas.

Graphical Abstract

Based on the graphical snapshot, this large-scale study of 13,418 Chinese adults investigated the interplay between physical activity (PA), air pollution (including O3 and SO2 beyond particulate matter), blood pressure (BP), and hypertension. Despite inconsistent prior evidence, our findings demonstrate that regular PA, quantified in MET-hours/week, significantly lowers BP and reduces hypertension risk. Crucially, PA effectively counteracts the adverse cardiovascular effects of air pollution exposure. Using generalized linear regression models, we identified specific thresholds of PA beyond which its protective benefits outweigh the detrimental impacts of pollutants. The turning points were approximately 336 MET-hours/week for overall air pollutants, 246 for O3, and 347 for SO2. In conclusion, this research underscores that engaging in sufficient levels of PA is a viable public health strategy for mitigating hypertension risk, even in populations exposed to significant air pollution.