Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children

J Am Coll Cardiol. 2009 Dec 15;54(25):2396-406. doi: 10.1016/j.jacc.2009.08.030.

Abstract

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 + or - 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 + or - 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 [VO(2)max]), 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, VO(2)max, 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 + or - 13.5 mm Hg vs. control 3.8 + or - 7.9 mm Hg, -0.8 + or - 1.5 standard deviation score [SDS] vs. 0.4 + or - 0.8 SDS), diastolic BP (-0.5 + or - 1.0 SDS vs. 0 + or - 1.4 SDS), hypertension rate (-12% vs. -1%), office BP, BMI z-score, abdominal fat, and VO(2)max. 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).

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis / blood*
  • Atherosclerosis / physiopathology*
  • Biomarkers / blood
  • Body Fat Distribution
  • Body Height / physiology
  • Body Mass Index
  • Body Weight / physiology
  • Carotid Artery, Common / diagnostic imaging
  • Child
  • Cholesterol, HDL / blood
  • Cross-Over Studies
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / physiology
  • Exercise / physiology*
  • Exercise Tolerance / physiology
  • Female
  • Humans
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Insulin Resistance / physiology
  • Male
  • Obesity / physiopathology
  • Obesity / therapy*
  • Oxygen Consumption / physiology
  • Physical Fitness / physiology
  • Puberty / physiology
  • Regional Blood Flow / physiology
  • Tunica Intima / diagnostic imaging
  • Tunica Media / diagnostic imaging
  • Ultrasonography
  • Vasodilation / physiology

Substances

  • Biomarkers
  • Cholesterol, HDL

Associated data

  • ClinicalTrials.gov/NCT00801645