Frontiers in public health · 2026
Labour-type physical activity, alcohol use and hypertension in rural older adults in Northeast China.
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Zhao Yongheng, Hou Gaixia, Gu Yimeng, Guo Zhuangzhuang, Zhang Dehui, Xi Xuefeng, Liu Limeng, Ning Lizhen
Аннотация
BACKGROUND: Hypertension is highly prevalent in older adults, yet evidence from resource-limited rural settings remains limited. In Northeast China, older residents are chronically exposed to cold-climate stress, labour-intensive agricultural routines, and entrenched social drinking norms, which may shape blood pressure risk profiles differently from urban cohorts.
METHODS: We analysed data from the 2025 Rural Elderly Health Examination Programme in Wangkui County, Heilongjiang, using a community-based cross-sectional design. Participants aged ≥65 years (N = 2,270) completed standardised examinations including bilateral blood pressure measurement, anthropometrics, and questionnaires assessing workload-related physical activity frequency-dominated by farming and domestic labour in this setting (hereafter termed occupational/labour-type physical activity, OPA; sessions/week)-and alcohol drinking frequency (occasions/week). Hypertension was defined as higher-arm SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Associations were estimated using multivariable logistic regression with HC3 robust standard errors, adjusting for age, sex, body mass index, haemoglobin concentration, and winsorized resting heart rate (complete-case N = 2,194).
RESULTS: Higher OPA frequency and alcohol drinking frequency were independently associated with greater odds of hypertension. Each additional OPA session per week was associated with a 23% higher odds of hypertension (adjusted OR [aOR] = 1.23, 95% CI: 1.16-1.32), and each additional drinking occasion per week was associated with a 20% higher odds (aOR = 1.20, 95% CI: 1.04-1.40). Estimated population-attributable fractions suggested a substantial potential burden associated with high-frequency OPA (≥3 sessions/week; 34.8%) and a smaller burden associated with any weekly drinking (>0/week; 4.7%); these estimates were interpreted cautiously given the cross-sectional design and the use of odds ratios for a common outcome. Sensitivity analyses using alternative hypertension definitions and continuous SBP/DBP models yielded directionally consistent findings, with steeper OPA gradients at older ages.
CONCLUSION: In this rural older-adult cohort, workload-related physical activity-reflecting largely non-volitional labour rather than leisure-time exercise-and alcohol use were associated with higher hypertension likelihood. Prevention strategies in cold-climate rural communities may benefit from workload-modification and recovery-protection approaches, safer organisation of labour tasks, and targeted reduction of weekly alcohol use.
METHODS: We analysed data from the 2025 Rural Elderly Health Examination Programme in Wangkui County, Heilongjiang, using a community-based cross-sectional design. Participants aged ≥65 years (N = 2,270) completed standardised examinations including bilateral blood pressure measurement, anthropometrics, and questionnaires assessing workload-related physical activity frequency-dominated by farming and domestic labour in this setting (hereafter termed occupational/labour-type physical activity, OPA; sessions/week)-and alcohol drinking frequency (occasions/week). Hypertension was defined as higher-arm SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Associations were estimated using multivariable logistic regression with HC3 robust standard errors, adjusting for age, sex, body mass index, haemoglobin concentration, and winsorized resting heart rate (complete-case N = 2,194).
RESULTS: Higher OPA frequency and alcohol drinking frequency were independently associated with greater odds of hypertension. Each additional OPA session per week was associated with a 23% higher odds of hypertension (adjusted OR [aOR] = 1.23, 95% CI: 1.16-1.32), and each additional drinking occasion per week was associated with a 20% higher odds (aOR = 1.20, 95% CI: 1.04-1.40). Estimated population-attributable fractions suggested a substantial potential burden associated with high-frequency OPA (≥3 sessions/week; 34.8%) and a smaller burden associated with any weekly drinking (>0/week; 4.7%); these estimates were interpreted cautiously given the cross-sectional design and the use of odds ratios for a common outcome. Sensitivity analyses using alternative hypertension definitions and continuous SBP/DBP models yielded directionally consistent findings, with steeper OPA gradients at older ages.
CONCLUSION: In this rural older-adult cohort, workload-related physical activity-reflecting largely non-volitional labour rather than leisure-time exercise-and alcohol use were associated with higher hypertension likelihood. Prevention strategies in cold-climate rural communities may benefit from workload-modification and recovery-protection approaches, safer organisation of labour tasks, and targeted reduction of weekly alcohol use.