Leisure-time cross-country skiing is associated with lower incidence of hypertension: A prospective cohort study

Objective: The prospective relationship between cross-country skiing and hypertension is uncertain. We aimed to assess the associations of leisure time cross-country skiing habits with incident hypertension in a general population. Methods: The frequency, average duration, and intensity of leisure cross-country skiing were assessed at baseline using a 12-month physical activity questionnaire in the KIHD prospective study of 1809 middle-aged men without hypertension. Hazard ratios (HRs) (95% confidence intervals) were calculated. Results: New onset diagnosis of hypertension was observed in 279 participants during a median (interquartile range) follow-up of 24.7 (18.1-26.8) years. Total volume and duration of cross-country skiing were continuously associated with hypertension risk. In analyses adjusted for hypertension risk factors, when compared to men with no cross-country skiing activity, the HRs (95% CIs) of incident hypertension were 0.75 (0.57 to 0.99) and 0.57 (0.41 to 0.79) for men who did 1-200 and > 200 MET hours per year of cross-country skiing, respectively. Compared to men with no cross-country skiing activity, the corresponding adjusted HRs (95% CIs) for incident hypertension were 0.72 (0.55 to 0.94) and 0.62 (0.44 to 0.86) for men who did 1-60 mins per week and > 60 mins week of cross-country skiing respectively. In subsidiary analyses, there were age-adjusted associations of cross-country skiing habits with risk of stroke and acute coronary events, but these were attenuated on further adjustment for several confounders. Cross-country skiing habits were associated with reduced risk of type 2 diabetes. Conclusion: Total volume as well as duration of leisure time cross-country skiing are each continuously, inversely and independently associated with future risk of hypertension in a Caucasian male population.