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Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children
Farpour-Lambert NJ, Aggoun Y, Marchand LM, Martin XE, Herrmann FR, Beghetti M
Journal of the American College of Cardiology 2009 Dec 15;54(25):2396-2406
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 +/- 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. 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, 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 mmHg versus control 3.8 +/- 7.9 mmHg, -0.8 +/- 1.5 standard deviation score (SDS) versus 0.4 +/- 0.8 SDS), diastolic BP (-0.5 +/- 1.0 SDS versus 0 +/- 1.4 SDS), hypertension rate (-12% versus -1%), office BP, BMI z-score, abdominal fat, and VO2max. 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.
With permission from Excerpta Medica Inc.

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