Physical Activity Reduces Systemic Blood Pressure and Improves Early Markers of Atherosclerosis in Pre-Pubertal Obese Children

ObjectivesThe 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.BackgroundHypertension and endothelial dysfunction are premature complications of obesity.MethodsWe 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.ResultsObese 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.ConclusionsA 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)