BACKGROUND Hypertension is the leading risk factor for death worldwide, and high levels of physical activity are associated with a lower incidence of hypertension. The associations of excessive levels of exercise and incidence of hypertension are less well known. We aim to compare the incidence of hypertension among 206 889 participants in a long-distance cross-country skiing event and 505 542 people randomly sampled from the general population (matched to the skiers on age, sex, and place of residence). METHODS Skiers' best performance (in percent of winning time) and number of completed races during the study period were associated with incidence of hypertension after participation in Vasaloppet. Hypertension was defined as prescription of blood pressure-lowering drugs as obtained from the national drug registry. Models were adjusted for sex, age, education, and income (total effect). RESULTS During a median time of risk of 8.3 years, skiers had a lower incidence of hypertension compared with nonskiers (hazard ratio [HR], 0.59 [95% CI, 0.58-0.60]). Among the skiers, better performance (in percent of winning time) in Vasaloppet was strongly associated with a lower incidence of hypertension (fastest fifth: HR, 0.41 [95% CI, 0.39-0.42]; slowest fifth: HR, 0.78 [95% CI, 0.75-0.81]). The association was nearly linear and did not differ between sexes. Among the skiers, a weaker association was seen between the number of completed races during the study period and the incidence of hypertension (1 race: HR, 0.63 [95% CI, 0.62-0.65]; >5 races: HR, 0.51 [95% CI, 0.50-0.53]). A subanalysis of 10 804 participants including adjustment for lifestyle factors showed similar results. CONCLUSIONS Participation in a long-distance skiing event was associated with a 41% lower incidence of hypertension over the next 8 years compared with nonparticipation. A near linear association between performance and incidence of hypertension was observed. This adds to the list of beneficial effects of intensive training, because hypertension is the leading risk factor of premature death globally.

中文翻译：

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远程滑雪和高血压的发病率：一项针对206889名远程滑雪越野赛参与者的队列研究。

背景技术高血压是世界范围内导致死亡的主要危险因素，而高水平的身体活动与较低的高血压发生率相关。过度运动与高血压发病之间的关系鲜为人知。我们的目的是比较206889名参加长距离越野滑雪比赛的参与者和505542名从普通人群中随机抽样的人（与年龄，性别和居住地匹配的滑雪者）的高血压发生率。方法研究期间，滑雪者的最佳表现（以赢得时间百分比表示）和完成比赛的次数与参加Vasaloppet后的高血压发生率有关。高血压定义为从国家药品注册局获得的降压药物处方。对模型进行了性别，年龄，教育程度和收入（总影响）的调整。结果在中位风险时间为8.3年期间，滑雪者的高血压发生率比非滑雪者要低（危险比[HR]为0.59 [95％CI，0.58-0.60]）。在滑雪者中，Vasaloppet的更好性能（以获胜时间百分比表示）与高血压的发生率较低（最快的第五名：HR，0.41 [95％CI，0.39-0.42]；最低的第五名：HR，0.78 [95％] CI，0.75-0.81]。关联几乎是线性的，并且性别之间没有差异。在滑雪者中，研究期间完成比赛的次数与高血压的发生之间存在较弱的关联（1个比赛：HR，0.63 [95％CI，0.62-0.65]；> 5个比赛：HR，0.51 [95 ％CI，0.50-0.53]。对10 804名参与者的亚分析（包括生活方式因素的调整）显示了相似的结果。结论与不参加运动相比，参加长距离滑雪活动与未来8年高血压发病率降低41％有关。观察到高血压的表现与发病率之间几乎呈线性关系。这增加了强化训练的有益效果，因为高血压是全球范围内过早死亡的主要危险因素。