ABC | Volume 114, Nº5, May 2020

Original Article Hypertension in Workers: The Role of Physical Activity and its Different Dimensions Uelito Everaldo Souza Ribeiro Junior 1 and Rita de Cassia Pereira Fernandes 2 Universidade Federal da Bahia - Programa de Pós-Graduação em Saúde, Ambiente e Trabalho,1 Salvador, BA - Brazil Universidade Federal da Bahia - Faculdade de Medicina da Bahia,2 Salvador, BA – Brazil Mailing Address: Uelito Everaldo Souza Ribeiro Junior • Universidade Federal da Bahia - Programa de Pós-Graduação em Saúde, Ambiente e Trabalho - Largo do Terreiro de Jesus, s/n. Postal Code 40110- 060, Centro Histórico Salvador, BA – Brazil E-mail: jr.vdgm@hotmail.com , ritafernandes@ufba.br Manuscript received February 06, 2019, revised manuscript June 08, 2019, accepted June 23, 2019 DOI: https://doi.org/10.36660/abc.20190065 Abstract Background: Physical activity, each type in its own manner, whether occupational, domestic or leisure, can play a significant role regarding high blood pressure (HBP). However, practicing physical activity only at leisure time, or in specific situations, can be insufficient to achieve the effective control of HBP. Objective: To analyze the isolated and cumulative effect of different types of physical activity and the prevalence of HBP among workers. Methods: A cross-sectional study with 1,070 Urban Cleaning and Footwear Industry workers in Bahia, who answered a survey, conducted by an interviewer on sociodemographic, occupational, lifestyle and hypertensive morbidity aspects. Weight, height, waist circumference and blood pressure were measured. Case of HBP: Systolic blood pressure ≥140 or diastolic blood pressure ≥90, or regular treatment for HBP. The occupational, domestic and leisure aspects of Physical Activity were studied. A multivariate analysis with Cox Regression was performed for cross-sectional studies. Results: The prevalence of HBP was 24%, being 37% among workers aged between 35-44 years, and 51% among workers aged between 45-54 years. The multivariate model showed that workers who were active in one form of physical activity only or no forms had 62% higher BP levels and that these levels were 25% higher among workers who were active in two out of three physical activity forms. Being a male, being older (> 31 years old) and being overweight were characteristics associated with HBP, with prevalence ratios of 1.62, 2.10 and 2.26, respectively. Conclusions: There was a cumulative effect of the form of physical activity on the occurrence of HBP. Classifying active subjects at work or at home as inactive persons by relying only on the leisure form can lead to methodological errors. (Arq Bras Cardiol. 2020; 114(5):755-761) Keywords: Hypertension; Workers; Urban Cleaning Service; Motor Activity; Anthropometry; Physical Exerton; Work; Socioeconomic Factors; Life Style. Brazil, a signatory to the World Health Organization’s Plan for the Prevention of Noncommunicable Chronic Diseases, committed to a 25% relative reduction in the prevalence of HBP and a 10% reduction in insufficient PA by the year 2025. This challenge highlights the relevance of HBP as a health problem. 5,6 Although a negative association between PA and HBP has been observed - more physically active people have lower HBP prevalence - there is a recent interest in the role of PA forms. In this sense, evidence about the forms has shown that individuals who are active at their work, leisure time and also practice sports have lower prevalence of HBP; 7 in addition, the lack of PA-O and PA-L significantly increases the risk of HBP. 8 However, occupational physical activities, considered strenuous, have also been associated with higher prevalence of hypertension, but this positive association of higher PA-O with hypertension has been attributed by some researchers to the role of unvalued confounders, such as psychological demands. 9 -11 In addition, the so-called “PA paradox” has been discussed, according to which the benefits of leisure activity could be minimized by high levels of PA-O. 12-14 Therefore, there are confluences and gaps regarding the role of the different PA forms on the occurrence of HBP. Thus, the objective of this study was to verify how forms of PA (PA-O, PA-L and PA-D) are associated with the occurrence of HBP, both alone and cumulatively. Introduction High blood pressure (HBP) is a chronic disease defined by blood pressure levels greater than or equal to 140/90 mmHg and represents one of the risk factors for cardiovascular diseases. On the other hand, it is known that insufficient or lack of physical activity (PA) is a modifiable risk factor for this condition. 1,2 Every movement produced by skeletal muscles that generates energy greater than the resting state is considered PA. An active person is an individual who practices at least 30 minutes of moderate-intensity PA five days a week. This does not include leisure only; on the contrary, the literature emphasizes the importance of approaching PA in different forms: leisure (PA- L), occupational (PA-O), domestic (PA-D) and displacement. 3,4 755