Associations between physical activity trajectories, hypertension, and type 2 diabetes among adults: a systematic...

Physical activity (PA) is a well-established protective factor for cardiometabolic health, yet the long-term impact of changes in PA on the risk of hypertension and type 2 diabetes (T2D) remains unclear. This systematic review and meta-analysis examined whether adults who maintained or increased their PA over time had a lower risk of developing hypertension and T2D compared to those who remained inactive.

This review and meta-analysis followed PRISMA guidelines. A comprehensive search was conducted using PubMed, Web of Science, and Embase. Thirteen studies met inclusion criteria. Risk of bias was assessed using a standardized tool. A random-effects model was used to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs), and heterogeneity was evaluated using the I² statistic. Of the 13 included studies, eight were eligible for meta-analysis. When comparing PA trajectories, reductions in disease risk among those who remained active or became active-relative to those who remained inactive-were observed only for T2D. Specifically, the inactive-to-active group showed a significantly lower risk of T2D (HR: 0.71; 95% CI: 0.52-0.98), and the active-to-active group demonstrated the greatest reduction (HR: 0.53; 95% CI: 0.45-0.62). However, no statistically significant associations were found between PA trajectories and hypertension risk. While the active-to-active group showed the lowest risk of hypertension (HR: 0.88; 95% CI: 0.74-1.05), the effect was not statistically significant.

PA trajectories characterized by maintenance or improvement over time were associated with a reduced risk of type 2 diabetes, but not hypertension.