title: Independent and combined effects of physical activity and sedentary behavior on blood pressure in adolescents: gender differences in two cross-sectional studies.
abstract: OBJECTIVE
  To examine the independent and combined association of physical activity (PA) and sedentary behavior (SB) on both systolic (SBP) and diastolic blood pressure (DBP) in adolescents from two observational studies.
  
  
  METHODS
  Participants from two cross-sectional studies, one conducted in Europe (n = 3,308; HELENA study) and the other in Brazil (n = 991; BRACAH study), were selected by complex sampling. Systolic and diastolic blood pressure (outcomes), PA and SB, both independently and combined, and potential confounders were analyzed. Associations were examined by multilevel linear regression.
  
  
  RESULTS
  Performing the recommended amount of PA (≥ 60 min/d) attenuated the effect of SB on DBP in BRACAH study girls and in boys from both studies. In contrast, PA did not attenuate the effects of SB on the SBP of girls in the HELENA study. The combination of less than recommended levels of PA with 2-4 h/d of sedentary behavior was found to be associated with increased SBP in boys from both studies.
  
  
  CONCLUSIONS
  Meeting current PA recommendations could mediate the association between SB and DBP in both sexes. In boys, the joint effect of low levels of PA and excessive sedentary activity increases SBP levels. Longitudinal studies are required to confirm these findings.
authors: Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil. augustocesar.demoraes@usp.br
authors: Augusto César Ferreira
authors: AC
authors: de Moraes
authors: Heráclito Barbosa
authors: HB
authors: Carvalho
authors: Juan Pablo
authors: JP
authors: Rey-López
authors: Luis
authors: L
authors: Gracia-Marco
authors: Laurent
authors: L
authors: Beghin
authors: Anthony
authors: A
authors: Kafatos
authors: David
authors: D
authors: Jiménez-Pavón
authors: Dénes
authors: D
authors: Molnar
authors: Stefaan
authors: S
authors: De Henauw
authors: Yannis
authors: Y
authors: Manios
authors: Kurt
authors: K
authors: Widhalm
authors: Jonatan R
authors: JR
authors: Ruiz
authors: Francisco B
authors: FB
authors: Ortega
authors: Michael
authors: M
authors: Sjöström
authors: Angela
authors: A
authors: Polito
authors: Raquel
authors: R
authors: Pedrero-Chamizo
authors: Ascensión
authors: A
authors: Marcos
authors: Frederic
authors: F
authors: Gottrand
authors: Luis A
authors: LA
authors: Moreno
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D057185:Sedentary Behavior; D017678:Sex Distribution; D011795:Surveys and Questionnaires
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