Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children.
OBJECTIVE
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).
Farpour-Lambert
Nathalie J
NJ
Pediatric Cardiology Unit, Department of Child and Adolescent, University Hospitals of Geneva, 6 rue Willy-Donze, 1211 Geneva 14, Switzerland. nathalie.farpourlambert@hcuge.ch
Aggoun
Yacine
Y
Marchand
Laetitia M
LM
Martin
Xavier E
XE
Herrmann
François R
FR
Beghetti
Maurice
M
D050197:Atherosclerosis / Q000097:blood* / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D050218:Body Fat Distribution; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D018592:Cross-Over Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D011627:Puberty / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology
D015415:Biomarkers; D008076:Cholesterol, HDL