Blog | Monday, May 19, 2014

QD: News Every Day--Exercise may lower hypertension, mortality in patients older than 70


Exercise capacity is associated with lower mortality risk in elderly men with hypertension, a study found.

Researchers at two VA centers in California and Washington, DC, enrolled more than 2,100 men with hypertension, all 7o years old or older, in routine exercise tolerance testing and recorded their peak workload in metabolic equivalents (METs). The subjects were classified into 4 categories based on peak METS and adjusted for age: very-low-fit, 2.0 to 4.0 METs (n=386); low-fit, 4.1 to 6.0 METs (n=1,058); moderate-fit, 6.1 to 8.0 METs (n=495); and high-fit >8.0 METs (n=214).

Results appeared at Hypertension.

All-cause mortality was tracked for a mean of 9 years, during which time there were 1,039 deaths, or 51.2 deaths per 1,000 person-years of follow-up. Every 1-MET increase in exercise capacity was associated with an 11% lower risk in mortality (HR=0.89; 95% CI, 0.86 to 0.93; P<0.001). Compared wwith the very-low-fit group, mortality risk in the low-fit group was 18% lower (HR=0.82; 95% CI, 0.70 to 0.95; P=0.011); 36% for the moderate-fit group (HR=0.64; 95% CI, 0.52 to 0.78; P<0.001), and 48% for the high-fit individuals (HR=0.52; 95% CI, 0.39 to 0.69; P<0.001).

The authors noted that the association between exercise capacity and mortality risk was much less significant with patients whose peak exercise output was ≥4 METs, and was at a level similar to that reported in much younger populations, suggesting that the health benefits of fitness are apparent regardless of age.

“First, relatively moderate increases in exercise capacity (>4.0 METs) lower mortality risk in men with hypertension aged ≥70 years,” they wrote. “Second, this level of exercise capacity is achievable by most elderly individuals engaging in a brisk walk of 20 to 40 minutes most days of the week. Because walking requires virtually no instructions, has a relatively low cost, carries a low risk of injury, and can be easily implemented to large populations, it may constitute an effective intervention to mitigate the deleterious effects of hypertension in the elderly.”