Dose-response relation between physical activity and blood pressure in youth.

UNLABELLED The dose-response relationship between physical activity (PA) and cardiovascular health in children and adolescents is unclear. Blood pressure (BP) is a practical and useful measure of cardiovascular health in youth. PURPOSE This study aims to examine the dose-response relationship between objectively measured PA and BP in children and adolescents. METHODS The sample included 1170 youth aged 8-17 yr from the 2003/04 U.S. National Health and Nutrition Examination Survey. PA was measured using Actigraph accelerometers (Ft. Walton Beach, FL, USA) over 7 d. Thresholds of 2000 and 3000 counts per minute were used to denote those minutes where the participants were engaged in total PA and moderate-to-vigorous intensity PA, respectively. BP was measured using standard procedures. Systolic and diastolic BP values were adjusted for age, height, and sex. Participants with adjusted BP values > or = 90th percentile were considered to have hypertension. Thirty-six fractional polynomial regression models were used to obtain the dose-response curve that best fit the relation between PA with systolic BP, diastolic BP, and hypertension. RESULTS Inverse dose-response relations were observed between total and moderate-to-vigorous PA with systolic and diastolic BP. The slopes of the curves were modest indicating a minimal influence of PA on mean BP values. The likelihood of having hypertension decreased in a curvilinear manner with increasing minutes of PA. At 30 and 60 min.d of moderate-to-vigorous PA, the odd ratios (95% confidence intervals) for hypertension were 0.50 (0.28-0.64) and 0.38 (0.17-0.52), respectively, in comparison to no PA. CONCLUSIONS A modest dose-response relation was observed between PA and mean systolic and diastolic BP values. PA did, however, have a strong gradient effect on BP when predicting hypertensive values. These results support the public health recommendation that children and youth accumulate at least 60 min of moderate-to-vigorous PA daily.

[1]  I. Janssen Physical activity guidelines for children and youth. , 2007, Canadian journal of public health = Revue canadienne de sante publique.

[2]  G. Kelley,et al.  Aerobic exercise and lipids and lipoproteins in children and adolescents: a meta-analysis of randomized controlled trials. , 2007, Atherosclerosis.

[3]  Shumei S. Sun,et al.  Systolic Blood Pressure in Childhood Predicts Hypertension and Metabolic Syndrome Later in Life , 2007, Pediatrics.

[4]  V. Stevens,et al.  Higher Self-reported Physical Activity Is Associated With Lower Systolic Blood Pressure: The Dietary Intervention Study in Childhood (DISC) , 2006, Pediatrics.

[5]  U. Ekelund,et al.  Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study) , 2006, The Lancet.

[6]  Christian Vilhelm,et al.  Moderate‐to‐Vigorous Physical Activity among Children: Discrepancies in Accelerometry‐Based Cut‐off Points , 2006, Obesity.

[7]  D. Hyman,et al.  Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity , 2006, Pediatrics.

[8]  Stewart Trost,et al.  Evidence based physical activity for school-age youth. , 2005, The Journal of pediatrics.

[9]  J. Fulton,et al.  Feasibility of using accelerometers to measure physical activity in young adolescents. , 2005, Medicine and science in sports and exercise.

[10]  U. Ekelund,et al.  Objectively measured physical activity correlates with indices of insulin resistance in Danish children. , 2004, International Journal of Obesity.

[11]  S. Going,et al.  Defining accelerometer thresholds for activity intensities in adolescent girls. , 2004, Medicine and science in sports and exercise.

[12]  Piero Quatto,et al.  Flexible meta-regression functions for modeling aggregate dose-response data, with an application to alcohol and mortality. , 2004, American journal of epidemiology.

[13]  D. Atkins,et al.  American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. , 2003, Circulation.

[14]  Z. Tran,et al.  The effects of exercise on resting blood pressure in children and adolescents: a meta-analysis of randomized controlled trials. , 2003, Preventive cardiology.

[15]  M. Litaker,et al.  Physical training improves insulin resistance syndrome markers in obese adolescents. , 2002, Medicine and science in sports and exercise.

[16]  Thomas N Robinson,et al.  Cardiovascular Health in Childhood: A Statement for Health Professionals From the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association , 2002, Circulation.

[17]  M. Puyau,et al.  Validation and calibration of physical activity monitors in children. , 2002, Obesity research.

[18]  J. Twisk Physical Activity Guidelines for Children and Adolescents , 2001, Sports medicine.

[19]  H C Kemper,et al.  Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. , 2000, Medicine and science in sports and exercise.

[20]  P. Freedson,et al.  Using objective physical activity measures with youth: how many days of monitoring are needed? , 2000, Medicine and science in sports and exercise.

[21]  J. Viikari,et al.  Associations between physical activity and risk factors for coronary heart disease: the Cardiovascular Risk in Young Finns Study. , 1997, Medicine and science in sports and exercise.

[22]  W. Mechelen,et al.  The relation between "long-term exposure" to lifestyle during youth and young adulthood and risk factors for cardiovascular disease at adult age. , 1997, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[23]  S. Srinivasan,et al.  Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. , 1995, American journal of hypertension.