Labour-type physical activity, alcohol use and hypertension in rural older adults in Northeast China.

Higher occupational/labour-type physical activity (OPA) frequency was independently associated with greater odds of hypertension in rural older adults.

• Each additional OPA session per week was associated with a 23% higher odds of hypertension (aOR = 1.23, 95% CI: 1.16–1.32).
• OPA was defined as workload-related physical activity frequency dominated by farming and domestic labour, measured in sessions/week.
• The estimated population-attributable fraction for high-frequency OPA (≥3 sessions/week) was 34.8%.
• Sensitivity analyses using alternative hypertension definitions and continuous SBP/DBP models yielded directionally consistent findings, with steeper OPA gradients at older ages.
• The analysis used multivariable logistic regression with HC3 robust standard errors in a complete-case sample of N = 2,194.

Higher alcohol drinking frequency was independently associated with greater odds of hypertension in rural older adults.

• Each additional drinking occasion per week was associated with a 20% higher odds of hypertension (aOR = 1.20, 95% CI: 1.04–1.40).
• Alcohol use was measured as drinking frequency in occasions/week.
• The estimated population-attributable fraction for any weekly drinking (>0/week) was 4.7%.
• The population-attributable fraction estimates were interpreted cautiously given the cross-sectional design and the use of odds ratios for a common outcome.

Hypertension prevalence was assessed in a community-based cross-sectional sample of rural older adults aged ≥65 years in Northeast China.

• Data were drawn from the 2025 Rural Elderly Health Examination Programme in Wangkui County, Heilongjiang Province.
• Total participants numbered N = 2,270, with a complete-case analytical sample of N = 2,194.
• Hypertension was defined as higher-arm SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg.
• Participants completed standardised examinations including bilateral blood pressure measurement, anthropometrics, and questionnaires.
• Covariates adjusted for included age, sex, body mass index, haemoglobin concentration, and winsorized resting heart rate.

The rural Northeast China setting involves chronic exposure to cold-climate stress, labour-intensive agricultural routines, and entrenched social drinking norms that may shape blood pressure risk profiles differently from urban cohorts.

• The study population was drawn from Wangkui County, Heilongjiang, a resource-limited rural setting.
• Older residents are described as chronically exposed to cold-climate stress and labour-intensive agricultural routines.
• The authors note that evidence from resource-limited rural settings remains limited despite high hypertension prevalence in older adults.
• OPA in this context reflected largely non-volitional labour rather than leisure-time exercise.

The authors recommend workload-modification, recovery-protection approaches, safer organisation of labour tasks, and targeted reduction of weekly alcohol use as prevention strategies for this population.

• Prevention strategies were specifically recommended for cold-climate rural communities.
• Workload-modification and recovery-protection approaches were highlighted given the non-volitional nature of OPA.
• Targeted reduction of weekly alcohol use was identified as a prevention target.
• The cross-sectional design precluded causal inference, and the authors acknowledged this limitation in interpreting population-attributable fraction estimates.