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. 2023 Dec 28;18(12):e0296333.
doi: 10.1371/journal.pone.0296333. eCollection 2023.

The mediation and interaction of the obesity index between moderate-vigorous recreational physical activity and hypertension

Bingqian Du  1   2   3 , Yuting Li  1   2 , Yun Xia  1   2 , Shan Wu  1   2 , Yuan Wei  1   2 , Zhihao Wang  1   2 , Shupei Wang  1   2 , Jiao Guo  4   5   6   7 , Qing Zhu  4   5   6 , Tianran Shen  1   2 , Qingsong Chen  1   2
Affiliations

The mediation and interaction of the obesity index between moderate-vigorous recreational physical activity and hypertension

Bingqian Du et al. PLoS One. .

Abstract

Previous studies showed that physical activity (PA) is concerned with hypertension (HTN). However, the mediation and interaction role of the obesity index: body mass index (BMI), waist-hip ratio (WHR), body fat rate (BFR) and visceral fat index (VFI) between PA and HTN has never been studied. Therefore, the purpose of this study was to assess the mediation and interaction of the obesity index between moderate-vigorous recreational physical activity (MVRPA) and HTN. We conducted a cross-sectional study of 4710 individuals aged 41 or older in Torch Development Zone, Zhongshan City. The mediation and interaction of the obesity index were evaluated by a four-way decomposition. 48.07% of participants had HTN among these groups. In the adjusted linear regression model, MVRPA was significantly correlated with WHR (β±SE = -0.005±0.002; P<0.05). Compared to sufficient MVRPA (odds ratio (OR) = 1.35), 95% (confidence interval (CI) = 1.17-1.56), insufficient MVRPA increased the risk of developing HTN. Furthermore, there were associations between BMI, WHR, BFR, VFI and HTN where the adjusted ORs and 95% CIs were 1.11 (1.09-1.13), 6.23 (2.61-14.90), 1.04 (1.03-1.06), 1.07 (1.06-1.09), respectively. The mediation analyses suggested that the impact of MVRPA on HTN risk may partly be explained by changes in obesity index, with a pure indirect mediation of WHR between MVRPA and HTN (P<0.05). Therefore, weight control, especially reducing abdominal obesity and maintaining adequate MVRPA, may lead to more proper control of HTN.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study.
Fig 2
Fig 2. Summary of four-way decomposition in causal mediation analysis (note: Bolded arrows represent each of the four component of the decomposition).
(A) CDE due to neither mediation nor interaction (in the current study: the effect of MVRPA has a direct effect on HTN), (B) INTref due to interaction alone, (C) INTmed due to both mediation and interaction, (D) PIE due to mediation alone (in the current study: the effect of MVRPA on HTN which purely goes through WHR).
See this image and copyright information in PMC

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