1. Higher cardiorespiratory fitness was associated with a decreased probability of high blood pressure, lowered insulin resistance and improved liver function in children with excess adiposity
2. Irrespective of adiposity status, higher cardiorespiratory fitness decreased blood pressure and increased kidney function
Evidence Rating Level: 2 (Good)
Children with high blood pressure (HBP) are more likely to experience cardiovascular disease compared to normotensive controls. Unlike in adults, there currently exists low quality evidence surrounding the relationship of cardiorespiratory fitness (CRF) and lowering HBP. As a result, the present study sought to evaluate the relationship between CRF with blood pressure status in children with normal adiposity and excessive adiposity (NA and EA).
This cross-sectional cohort study included 211 children (7-10 yrs old; EA=39, NA=172) from the Arkansas Active Kids (AAK) study. 69% of children in the EA group had HBP compared to 24% in the NA group. Children were excluded if they had severe persistent asthma, metabolic/endocrine diseases, were on hormonal replacement therapy, cancer, autoimmune diseases or bleeding disorders. Children attended a one visit study where clinical markers (plasma lipids, estimated glomerular filtration rate, alanine aminotransferase, and insulin resistance) were obtained. Study outcomes assessed the relationship between CRF and blood pressure, cardiovascular disease risk factors, and kidney function. CRF was measured using a pediatric cycle ergometer and body composition was measured using dual-energy x-ray absorptiometry.
Results showed that for children with EA, higher CRF was protective against HBP, insulin resistance and liver injury. In addition, children with NA and EA both experienced improved blood pressure percentiles and kidney function with higher CRF. This study was limited by the cross-sectional design which may have overestimated blood pressure in certain cases. However, given that this study assessed blood pressure using the most updated guidelines, the present findings suggest that greater emphasis could be placed in increasing CRF in children where HBP is a concern.
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