Quarterly Focus Issue: Prevention/Outcomes
Clinical Research: Atherosclerosis Markers and Physical Activity in Children
Physical Activity Reduces Systemic Blood Pressure and Improves Early Markers of Atherosclerosis in Pre-Pubertal Obese Children

https://doi.org/10.1016/j.jacc.2009.08.030Get rights and content
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Objectives

The aim of this study was to determine the effects of physical activity on systemic blood pressure (BP) and early markers of atherosclerosis in pre-pubertal obese children.

Background

Hypertension and endothelial dysfunction are premature complications of obesity.

Methods

We performed a 3-month randomized controlled trial with a modified crossover design: 44 pre-pubertal obese children (age 8.9 ± 1.5 years) were randomly assigned (1:1) to an exercise (n = 22) or a control group (n = 22). We recruited 22 lean children (age 8.5 ± 1.5 years) for baseline comparison. The exercise group trained 60 min 3 times/week during 3 months, whereas control subjects remained relatively inactive. Then, both groups trained twice/week during 3 months. We assessed changes at 3 and 6 months in office and 24-h BP, arterial intima-media thickness (IMT) and stiffness, endothelial function (flow-mediated dilation), body mass index (BMI), body fat, cardiorespiratory fitness (maximal oxygen consumption [VO2max]), physical activity, and biological markers.

Results

Obese children had higher BP, arterial stiffness, body weight, BMI, abdominal fat, insulin resistance indexes, and C-reactive protein levels, and lower flow-mediated dilation, VO2max, physical activity, and high-density lipoprotein cholesterol levels than lean subjects. At 3 months, we observed significant changes in 24-h systolic BP (exercise −6.9 ± 13.5 mm Hg vs. control 3.8 ± 7.9 mm Hg, −0.8 ± 1.5 standard deviation score [SDS] vs. 0.4 ± 0.8 SDS), diastolic BP (−0.5 ± 1.0 SDS vs. 0 ± 1.4 SDS), hypertension rate (−12% vs. −1%), office BP, BMI z-score, abdominal fat, and VO2max. At 6 months, change differences in arterial stiffness and IMT were significant.

Conclusions

A regular physical activity program reduces BP, arterial stiffness, and abdominal fat; increases cardiorespiratory fitness; and delays arterial wall remodeling in pre-pubertal obese children. (Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children: A Randomized Controlled Trial; NCT00801645)

Key Words

atherosclerosis
child
hypertension
obesity
physical activity

Abbreviations and Acronyms

ANCOVA
analysis of covariance
ANOVA
analysis of variance
BMI
body mass index
CVD
cardiovascular disease
DBP
diastolic blood pressure
Einc
incremental elastic modulus
FMD
flow-mediated dilation
HDL-C
high-density lipoprotein cholesterol
HOMA-IR
homeostasis assessment model of insulin resistance
HTN
hypertension
IMT
intima-media thickness
LDL-C
low-density lipoprotein cholesterol
NTGMD
nitroglycerin-mediated dilation
SBP
systolic blood pressure
SDS
standard deviation score
TC
total cholesterol
TG
triglyceride
VO2max
maximal oxygen consumption

Cited by (0)

This work was supported by the Swiss National Science Foundation (#3200B0-103853), Bern, and the Geneva University Hospitals Research and Development Fund.