Physical Activity, Sleep, and Hypertension Among U.S. Middle and Older Adults: NHANES Insights

TL;DR

This study explores how physical activity and sleep affect hypertension in U.S. middle and older adults using national health survey data.

Contribution

The study provides new insights into how meeting physical activity guidelines and adequate sleep can lower hypertension risk in adults.

Findings

Meeting physical activity guidelines was linked to lower odds of hypertension.

Short sleep duration was associated with higher odds of hypertension.

Older adults and lower-income groups showed stronger associations between lifestyle and hypertension.

Abstract

Hypertension is a primary risk factor for cardiovascular disease. Physical activity and sleep are critical determinants of blood pressure. This study investigated associations between physical activity, sleep duration, and hypertension in middle-aged and older adults. We analyzed cross-sectional data from the National Health and Nutrition Examination Survey of adults aged 40-80 years (N = 9,133). Hypertension was defined as systolic blood pressure ≥130 mmHg, diastolic blood pressure ≥80 mmHg, or current antihypertensive medication use. Physical activity was categorized as not meeting guidelines (< 500 MET-min/wk), meeting guidelines (≥500-< 1000 MET-min/wk), and exceeding guidelines (≥1000 MET-min/wk). Sleep duration was classified as short (< 7 hours), recommended (7–9 hours), or long (>9 hours). Descriptive statistical analyses were performed. Logistic regression was used to estimate the associations between lifestyle behaviors and hypertension, with adjustments made for sociodemographic and clinical factors. Overall, 61.2% of participants had hypertension. Middle-aged adults (40–64 years) comprised 69% of the sample; older adults (65–80 years) comprised 31%. Meeting physical activity guidelines was associated with lower odds of hypertension (adjusted OR = 0.78, 95% CI: 0.65–0.94, p < 0.01). Short sleep was associated with higher odds of hypertension (adjusted OR = 1.32, 95% CI: 1.12–1.55, p < 0.01). No significant association was observed for long sleep. Stratified analyses suggested stronger associations among older adults and lower-income groups. Physical activity and sleep are independently associated with hypertension in U.S. middle and older adults. Integrated lifestyle interventions may reduce hypertension burden, particularly among high-risk populations.