We aimed to characterize physical activity (PA) trajectories across adulthood and to estimate their association with incident hypertension risk. Methods: Data were obtained from the China Health and Nutrition Survey (CHNS) conducted during 2004-2011. Group-based trajectory modeling (GBTM) was used to identify distinct groups of PA trajectories. The Cox proportional hazards model was used to investigate the association. Results: A total of 11,162 participants whose PA was repeatedly estimated by self-report from questionnaires two to four times in the CHNS were included in our study. During the 5.4 years of follow-up, 3824 incident hypertension cases were identified. Five distinct PA trajectories were identified in men: light and slight decline, light and gradual decline then sharp rise, light to medium-heavy then decline, medium-heavy and gradual decline, and heavy and sharp decline. Two distinct PA trajectories were identified in women: light and stable, and medium and gradual decline. The PA trajectory of medium-heavy and gradual decline was significantly associated with decreased risk of hypertension in men, with the hazard ratios and 95% confidence intervals (CI) being 0.80 (0.63, 0.99), 0.74 (0.59, 0.93), 0.76 (0.60, 0.96), and 0.70 (0.55, 0.88) in models 1-4, respectively. Conclusions: Our study identified five distinct long-term PA trajectories in men and two distinct trajectories in women. The PA trajectory of medium-heavy PA in early adulthood followed by gradual decline was found to be significantly associated with a decreased risk of hypertension in later life in men.

Background We aimed to characterize the physical activity (PA) trajectories across adulthood and estimate their association with incident hypertension risk.Methods Data were obtained from the China Health and Nutrition Survey (CHNS) conducted during 2004–2011. Group-based trajectory modeling (GBTM) was used to identify distinct groups of PA trajectories. The Cox proportional hazard model was used to investigate the association between each PA trajectory group and incident hypertension.Results A total of 11,162 participants whose PA was repeatedly measured two to four times in the CHNS during 2004–2011 were included in our study. During the 5.4 years of follow-up, 3,824 incident hypertension cases were identified. Five distinct PA trajectories were identified in men: light and slight decline, light and gradual decline then sharp rise, light to medium-heavy then decline, medium-heavy and persistent decline, and heavy and sharp decline. Two distinct PA trajectories were identified in women: light and stable, and medium and gradual decline. The PA trajectory of medium-heavy and persistent decline was significantly associated with decreased risk of hypertension in men, with the hazard ratios and 95% confidence intervals being 0.80 (0.63, 0.99), 0.74 (0.59, 0.93), 0.76 (0.60, 0.96), and 0.70 (0.55, 0.88) in model 1, model 2, model 3, and model 4, respectively.Conclusions Our study identified five distinct long‐term PA trajectories in men and two distinct trajectories in women. The PA trajectory of medium-heavy PA in early adulthood (at 18–37 years) followed by persistent decline (at 38–70 years) was found to be significantly associated with a decreased risk of hypertension in later life in men.