{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:43:08Z","timestamp":1792082588691,"version":"4.4.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analysed data from the 2025 Rural Elderly Health Examination Programme in Wangkui County, Heilongjiang, using a community-based cross-sectional design. Participants aged \u226565\u202fyears (\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f2,270) completed standardised examinations including bilateral blood pressure measurement, anthropometrics, and questionnaires assessing workload-related physical activity frequency\u2014dominated by farming and domestic labour in this setting (hereafter termed occupational\/labour-type physical activity, OPA; sessions\/week)\u2014and alcohol drinking frequency (occasions\/week). Hypertension was defined as higher-arm SBP\u202f\u2265\u202f140\u202fmmHg and\/or DBP\u202f\u2265\u202f90\u202fmmHg. 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                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f2,194).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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]\u202f=\u202f1.23, 95% CI: 1.16\u20131.32), and each additional drinking occasion per week was associated with a 20% higher odds (aOR\u202f=\u202f1.20, 95% CI: 1.04\u20131.40). Estimated population-attributable fractions suggested a substantial potential burden associated with high-frequency OPA (\u22653 sessions\/week; 34.8%) and a smaller burden associated with any weekly drinking (&amp;gt;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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this rural older-adult cohort, workload-related physical activity\u2014reflecting largely non-volitional labour rather than leisure-time exercise\u2014and 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1748721","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:04:38Z","timestamp":1772003078000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Labour-type physical activity, alcohol use and hypertension in rural older adults in Northeast China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yongheng","family":"Zhao","sequence":"first","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Institute of Gerontology, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaixia","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Institute of Gerontology, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimeng","family":"Gu","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuangzhuang","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Dongcheng Community Health Service Center","place":["Wangkui County, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Xi","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Institute of Gerontology, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limeng","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health Sciences, Mudanjiang Normal University","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhen","family":"Ning","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Institute of Gerontology, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]},{"name":"School of Physical Education, Suihua University","place":["Suihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s11906-023-01289-7","article-title":"Managing hypertension in older adults","volume":"26","author":"Egan","year":"2024","journal-title":"Curr Hypertens Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","author":"Zhou","year":"2021","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s12872-022-02769-5","article-title":"Urban-rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults from 2011 to 2015: a repeated cross-sectional study","volume":"22","author":"Cheng","year":"2022","journal-title":"BMC Cardiovasc Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1038\/s41598-024-52009-3","article-title":"Risk factors and prevalence of hypertension in older adults from south-eastern Poland: an observational study","volume":"14","author":"Leszczak","year":"2024","journal-title":"Sci Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1161\/HYPERTENSIONAHA.121.17281","article-title":"Occupational physical activity and new-onset hypertension: a nationwide cohort study in China","volume":"78","author":"Li","year":"2021","journal-title":"Hypertension"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.1161\/HYPERTENSIONAHA.124.22703","article-title":"Alcohol intake and risk of hypertension: a systematic review and dose-response meta-analysis of nonexperimental cohort studies","volume":"81","author":"Cecchini","year":"2024","journal-title":"Hypertension"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"104470","DOI":"10.1016\/j.ijnurstu.2023.104470","article-title":"Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: a systematic overview of the literature","volume":"141","author":"Janssen","year":"2023","journal-title":"Int J Nurs Stud"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e056270","DOI":"10.1136\/bmjopen-2021-056270","article-title":"Effect of leisure-time physical activity in controlling hypertension: a systematic review and meta-analysis protocol","volume":"11","author":"Shariful Islam","year":"2021","journal-title":"BMJ Open"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1186\/1471-2458-12-1002","article-title":"Occupational and leisure time physical activity in contrasting relation to ambulatory blood pressure","volume":"12","author":"Clays","year":"2012","journal-title":"BMC Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1136\/bjsports-2017-097965","article-title":"The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does","volume":"52","author":"Holtermann","year":"2018","journal-title":"Br J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1136\/bjsports-2024-108117","article-title":"Associations of occupational and leisure-time physical activity with all-cause mortality: an individual participant data meta-analysis","volume":"58","author":"Coenen","year":"2024","journal-title":"Br J Sports Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e074697","DOI":"10.1136\/bmjopen-2023-074697","article-title":"Association between alcohol consumption and risk of hyperuricaemia among adults: a large cross-sectional study in Chongqing, China","volume":"13","author":"Chen","year":"2023","journal-title":"BMJ Open"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1093\/ije\/dyt078","article-title":"Alcohol consumption in 0.5 million people from 10 diverse regions of China: prevalence, patterns and socio-demographic and health-related correlates","volume":"42","author":"Millwood","year":"2013","journal-title":"Int J Epidemiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.alcohol.2019.09.004","article-title":"Association between alcohol consumption and hypertension in Chinese adults: findings from the CHNS","volume":"83","author":"Zhao","year":"2020","journal-title":"Alcohol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"107258","DOI":"10.1016\/j.cct.2023.107258","article-title":"Protocol: implementation evaluation of a combination intervention for sustainable blood pressure control in rural KwaZulu-Natal, South Africa (IMPACT BP): a three-arm, unblinded, parallel group individually randomized clinical trial","volume":"131","author":"Sithole","year":"2023","journal-title":"Contemp Clin Trials"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"CD010022","DOI":"10.1002\/14651858.CD010022.pub2","article-title":"Alcohol intake reduction for controlling hypertension","volume":"2020","author":"Acin","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1161\/HYPERTENSIONAHA.123.21354","article-title":"Social determinants of health and disparities in hypertension and cardiovascular diseases","volume":"81","author":"Chaturvedi","year":"2024","journal-title":"Hypertension"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"414","DOI":"10.12799\/jkachn.2018.29.4.414","article-title":"Analysis of spatial distribution of hypertension prevalence and its related factors based on the model of social determinants of health","volume":"29","author":"Kim","year":"2018","journal-title":"J Korean Acad Community Health Nurs"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2378503","DOI":"10.1080\/23288604.2024.2378503","article-title":"Preparedness, challenges, and opportunities for digital intervention for chronic disease management: a qualitative study in rural areas of South Korea","volume":"10","author":"Lee","year":"2024","journal-title":"Health Syst Reform"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"864","DOI":"10.3390\/land13060864","article-title":"Understanding outdoor cold stress and thermal perception of the elderly in severely cold climates: a case study in Harbin","volume":"13","author":"He","year":"2024","journal-title":"Land"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1084611","DOI":"10.3389\/fcvm.2023.1084611","article-title":"A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes","volume":"10","author":"Fan","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"ref23","year":""},{"key":"ref24","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1057\/s41599-024-04295-5","article-title":"Nip it in the bud: the impact of China\u2019s large-scale free physical examination program on health care expenditures for elderly people","volume":"12","author":"Ma","year":"2025","journal-title":"Humanit Soc Sci Commun"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.2147\/PPA.S312806","article-title":"Willingness to receive periodic health examination based on the health belief model among the elderly in rural China: a cross-sectional study","volume":"15","author":"Zhang","year":"2021","journal-title":"PPA"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e22324","DOI":"10.1002\/jcla.22324","article-title":"Quality specification and status of internal quality control of cardiac biomarkers in China from 2011 to 2016","volume":"32","author":"Li","year":"2017","journal-title":"J Clin Lab Anal"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World medical association declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","year":"2013","journal-title":"JAMA"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1472-6963-14-16","article-title":"The use of annual physical examinations among the elderly in rural China: a cross-sectional study","volume":"14","author":"Sun","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12939-017-0585-z","article-title":"Rural\u2013urban difference in the use of annual physical examination among seniors in Shandong, China: a cross-sectional study","volume":"16","author":"Ge","year":"2017","journal-title":"Int J Equity Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1017\/S1474746422000161","article-title":"Factors associated with preventive care utilisation among Chinese older adults: evidence from the 2018 Chinese longitudinal healthy longevity survey","volume":"23","author":"Lee","year":"2024","journal-title":"Soc Policy Soc"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"19","DOI":"10.21037\/jlpm-21-19","article-title":"A current analysis of quality indicators in Chinese clinical laboratories","volume":"6","author":"Saleem","year":"2021","journal-title":"J Lab Precis Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.jshs.2016.07.004","article-title":"Physical activity among older Chinese adults living in urban and rural areas: a review","volume":"5","author":"Zhu","year":"2016","journal-title":"J Sport Health Sci"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"11956","DOI":"10.3390\/su141911956","article-title":"Development of physical activity guidelines for a healthy China using the life cycle concept: the perspective of policy tools from five countries","volume":"14","author":"Wang","year":"2022","journal-title":"Sustainability"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e072474","DOI":"10.1136\/bmjopen-2023-072474","article-title":"Consumption frequencies of beverages and the hypertension risk in adults: a cohort study in China","volume":"13","author":"Wang","year":"2023","journal-title":"BMJ Open"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1161\/HYPERTENSIONAHA.120.15026","article-title":"2020 International Society of Hypertension Global Hypertension Practice Guidelines","volume":"75","author":"Unger","year":"2020","journal-title":"Hypertension"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"621","DOI":"10.26599\/1671-5411.2023.09.008","article-title":"2023 China guidelines for lipid management","volume":"20","author":"Li","year":"2023","journal-title":"J Geriatr Cardiol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12944-021-01541-6","article-title":"Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends","volume":"20","author":"Lao","year":"2021","journal-title":"Lipids Health Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"922824","DOI":"10.3389\/fnut.2022.922824","article-title":"Association of obesity profiles with type 2 diabetes in Chinese adults: findings from the China health and nutrition survey","volume":"9","author":"Zhang","year":"2022","journal-title":"Front Nutr"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12872-015-0177-z","article-title":"Validation of Omron HBP-1300 professional blood pressure monitor based on auscultation in children and adults","volume":"16","author":"Meng","year":"2016","journal-title":"BMC Cardiovasc Disord"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/s0895-7061(99)00028-x","article-title":"Association between resting heart rate and hypertension treatment in a general population","volume":"12","author":"Ferri\u00e8res","year":"1999","journal-title":"Am J Hypertens"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e297","DOI":"10.1371\/journal.pmed.0040297","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration","volume":"4","author":"Vandenbroucke","year":"2007","journal-title":"PLoS Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4103\/aca.ACA_157_18","article-title":"Descriptive statistics and normality tests for statistical data","volume":"22","author":"Mishra","year":"2019","journal-title":"Ann Card Anaesth"},{"key":"ref43","year":""},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of blood pressure in humans: a scientific statement from the American Heart Association","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1080\/00031305.2000.10474549","article-title":"Using heteroscedasticity consistent standard errors in the linear regression model","volume":"54","author":"Long","year":"2000","journal-title":"Am Stat"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e014486","DOI":"10.1161\/JAHA.119.014486","article-title":"Hypertension in rural India: the contribution of socioeconomic position","volume":"9","author":"Thrift","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e0201616","DOI":"10.1371\/journal.pone.0201616","article-title":"High prevalence of hypertension in an agricultural village in Madagascar","volume":"13","author":"Manus","year":"2018","journal-title":"PLoS One"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S0140-6736(22)00847-9","article-title":"Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the global burden of disease study 2020","volume":"400","year":"2022","journal-title":"Lancet"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"2255026","DOI":"10.1080\/21642850.2023.2255026","article-title":"The allostatic load model: a framework to understand the cumulative multi-system impact of work-related psychosocial stress exposure among firefighters","volume":"11","author":"Igboanugo","year":"2023","journal-title":"Health Psychol Behav Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1038\/s42003-025-08939-3","article-title":"Integrating allostasis and emerging technologies to study complex diseases","volume":"8","author":"Park","year":"2025","journal-title":"Commun Biol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s00391-024-02324-1","article-title":"Psychosocial and biological pathways to aging","volume":"57","author":"Gellert","year":"2024","journal-title":"Z Gerontol Geriat"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e14","DOI":"10.3346\/jkms.2020.35.e14","article-title":"Effect modification of acetaldehyde dehydrogenase 2 rs671 polymorphism on the association between alcohol intake and blood pressure: the Dong-gu study","volume":"35","author":"Kim","year":"2020","journal-title":"J Korean Med Sci"},{"key":"ref53","first-page":"10767","article-title":"Aldehyde dehydrogenase 2 (ALDH2) Glu504Lys polymorphism is associated with hypertension risk in Asians: a meta-analysis","volume":"8","author":"Jia","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1016\/j.amepre.2025.02.016","article-title":"Allostatic load and cardiovascular disease: a systematic review","volume":"68","author":"Evans","year":"2025","journal-title":"Am J Prev Med"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"451","DOI":"10.3389\/fphys.2020.00451","article-title":"Exercise-related oxidative stress as mechanism to fight physical dysfunction in neuromuscular disorders","volume":"11","author":"Siciliano","year":"2020","journal-title":"Front Physiol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1123\/jmpb.2023-0030","article-title":"Context matters: the importance of physical activity domains for public health","volume":"6","author":"Quinn","year":"2023","journal-title":"J Meas Phys Behav"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"4653","DOI":"10.3390\/ijms24054653","article-title":"The impact of aerobic exercise on HDL quantity and quality: a narrative review","volume":"24","author":"Franczyk","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"521","DOI":"10.3961\/jpmph.24.302","article-title":"Is farming a risk occupation for cardio-cerebrovascular diseases? A scoping review on cardio-cerebrovascular disease risk in farmers","volume":"57","author":"Kim","year":"2024","journal-title":"J Prev Med Public Health"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/23328940.2017.1414014","article-title":"Cardiovascular diseases, cold exposure and exercise","volume":"5","author":"Ik\u00e4heimo","year":"2018","journal-title":"Temperature (Austin)"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1080\/23328940.2015.1008890","article-title":"Responses of the hands and feet to cold exposure","volume":"2","author":"Cheung","year":"2015","journal-title":"Temperature (Austin)"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00391-019-01525-3","article-title":"Postural hemodynamic parameters in older persons have a seasonal dependency: a pilot study","volume":"53","author":"Trozic","year":"2020","journal-title":"Z Gerontol Geriat"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.5551\/jat.31641","article-title":"Heavy alcohol consumption is associated with impaired endothelial function: the circulatory risk in communities study (CIRCS)","volume":"23","author":"Tanaka","year":"2016","journal-title":"J Atheroscler Thromb"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"219","DOI":"10.35946\/arcr.v38.2.06","article-title":"Alcohol\u2019s effects on the cardiovascular system","volume":"38","author":"Piano","year":"2017","journal-title":"Alcohol Res Curr Rev"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s10286-019-00618-8","article-title":"Alcohol-induced autonomic dysfunction: a systematic review","volume":"30","author":"Julian","year":"2020","journal-title":"Clin Auton Res"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"e0177023","DOI":"10.1371\/journal.pone.0177023","article-title":"Positive association between ALDH2 rs671 polymorphism and essential hypertension: a case-control study and meta-analysis","volume":"12","author":"Wu","year":"2017","journal-title":"PLoS One"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.yjmcc.2015.04.011","article-title":"Vascular biology of ageing\u2014implications in hypertension","volume":"83","author":"Harvey","year":"2015","journal-title":"J Mol Cell Cardiol"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1161\/01.hyp.33.6.1392","article-title":"Age-related abnormalities in arterial compliance identified by pressure pulse contour analysis: aging and arterial compliance","volume":"33","author":"McVeigh","year":"1999","journal-title":"Hypertension"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1097\/HJH.0000000000004134","article-title":"Trend in hypertension prevalence, awareness, treatment, and control rates among adult residents in Guangdong province, southern China, 2002~2022","volume":"43","author":"Jiang","year":"2025","journal-title":"J Hypertens"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"e8015","DOI":"10.7717\/peerj.8015","article-title":"The urban-rural disparity in the prevalence and risk factors of hypertension among the elderly in China\u2014a cross-sectional study","volume":"7","author":"Song","year":"2019","journal-title":"PeerJ"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"16098","DOI":"10.1038\/s41598-018-34617-y","article-title":"Hypertension and physical activity in middle-aged and older adults in China","volume":"8","author":"You","year":"2018","journal-title":"Sci Rep"}],"updated-by":[{"DOI":"10.3389\/fpubh.2026.1821356","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000}}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1748721\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:38:17Z","timestamp":1773851897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1748721\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":70,"alternative-id":["10.3389\/fpubh.2026.1748721"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1748721","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"1748721"}}