Physical activity for the prevention and treatment of major chronic disease: an overview of systematic reviews Intrapersonal, social and physical environmental determinants of moderate-to-vigorous physical activity in working-age women: a systematic review protocol Legacy Effect of Delayed Blood Pressure-Lowering Pharmacotherapy in Middle-Aged Individuals Stratified by Absolute Cardiovascular Disease Risk: Protocol for a Systematic Review Effects of exercise and weight loss on blood pressure during daily life. Increasing daily walking lowers blood pressure in postmenopausal women. Physical Activity Level and Colorectal Cancer Mortality Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Physical activity, change in blood pressure and predictors of mortality in older South Africans--a 2-year follow-up study. Activity behaviors in schoolchildren and subsequent 5-yr change in blood pressure. Exercise in obese pregnant women: positive impacts and current perceptions Hypertensive men who exercise regularly have lower rate of cardiovascular mortality. Impact of Moderate-Intensity and Vigorous-Intensity Physical Activity on Mortality Association between physical activity and blood pressure in prepubertal children A Culturally Adapted Telecommunication System to Improve Physical Activity, Diet Quality, and Medication Adherence Among Hypertensive African–Americans: A Randomized Controlled Trial Long-term follow-up of cardiovascular risk factors after exercise training in obese children. Exercise and well-being: a review of mental and physical health benefits associated with physical activity Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population: a quasi-experimental study Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial Effect of resistance exercises on function in older adults with osteoporosis or osteopenia: a systematic review. Physical activity trajectories and mortality: population based cohort study Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes. Intensity of leisure-time physical activity and cancer mortality in men Exercise Interventions in Children with Cancer: A Review
Background The evidence that higher levels of physical activity and /or lower levels of physical inactivity are associated with beneficial health-related outcomes stems mainly from observational studies . Findings from these studies often differ from r and omised controlled trials and systematic review s currently demonstrate mixed results , due partly to heterogeneity in physical activity interventions , method ologies used and population s studied . As a result , translation into clinical practice has been difficult . It is therefore essential that an overview is carried out to compare and contrast systematic review s , and to identify those physical activity interventions that are the most effective in preventing and /or treating major chronic disease . This protocol has been registered on PROSPERO 2013 : CRD42013003523 . Methods We will carry out an overview of Cochrane systematic review s. We will search the Cochrane Data base of Systematic Review s for systematic review s of r and omised controlled trials that have a primary focus on disease-related outcomes . We will restrict review s to those in selected major chronic diseases . Two authors will independently screen search outputs , select studies , extract data and assess the quality of included review s using the assessment of multiple systematic review s tool ; all discrepancies will be resolved by discussing and reaching a consensus , or by arbitration with a third author . The data extraction form will summarise key information from each review , including details of the population ( s ) ( for example , disease condition ) , the context ( for example , prevention , treatment or management ) , the participants , the intervention(s ) , the comparison(s ) and the outcomes . The primary outcomes of interest are the prevention of chronic disease and /or improved outcomes , in the treatment or management of chronic disease . These outcomes will be summarised and presented for individual chronic diseases ( for example , any change in blood pressure in hypertension or glucose control in diabetes ) . Secondary outcomes of interest are to describe the structure and delivery of physical activity interventions  across chronic disease conditions and adverse events associated with physical activity . Discussion We anticipate that our results could inform research ers , guideline groups and policymakers of the most efficacious physical activity interventions in preventing and /or managing major chronic disease Background The majority of North American adult females do not meet current physical activity recommendations ( 150 min of moderate-to-vigorous intensity physical activity ( MVPA ) per week accrued in ≥10 min bouts ) ultimately placing themselves at increased risk of morbidity and mortality . Working-age females face particular challenges in meeting physical activity recommendations as they have multiple dem and s , including occupational , family and social dem and s. To develop effective interventions to increase MVPA among working-age females , it is necessary to identify and underst and the strongest modifiable determinants influencing these behaviours . Therefore , the objective of this systematic review is to examine the available evidence to identify intrapersonal , social and environmental determinants of MVPA among working-age females . Methods / Design Six electronic data bases will be search ed to identify all prospect i ve cohort studies that report on intrapersonal , social and /or environmental determinants of  MVPA  in working-age females . Grey literature sources including theses , published conference abstract s and websites from relevant organizations will also be included . Articles that report on intrapersonal ( e.g. health status , self-efficacy , socio-economic status ( SES ) , stress , depression ) , social environmental ( e.g. crime , safety , area SES , social support , climate and capital , policies ) , and environmental ( e.g. weather , workplace , home , neighbourhood , recreation environment , active transportation ) determinants of MVPA  in a working-age ( mean age 18–65 years ) female population will be included . Risk of bias will be assessed within and across all included studies using the Tool to Assess Risk of Bias in Cohort Studies and the Grade s of Recommendation , Assessment , Development and Evaluation approach . Harvest plots will be used to synthesize results across all determinants , and meta-analyses will be conducted where possible among studies with sufficient homogeneity . Discussion This review will provide a comprehensive examination of evidence in this field and will serve to highlight gaps for future research on the determinants of MVPA in working-age females and ultimately inform intervention design . Systematic review registration PROSPERO : CRD42014009750 Background Many national and international guidelines recommend that the initiation of blood pressure (BP)-lowering drug treatment for the primary prevention of cardiovascular disease ( CVD ) should no longer be based on BP level alone , but on absolute cardiovascular risk . While BP-lowering drug treatment is beneficial in high-risk individuals at any level of elevated BP , clinicians are concerned about legacy effects on patients with low-to-moderate risk and mildly elevated BP who remain “ untreated ” . Objective We aim to investigate the legacy effect of delayed BP-lowering pharmacotherapy in middle-aged individuals ( 45 - 65 years ) with mildly elevated BP ( systolic BP 140 - 159 mmHg and /or diastolic BP 90 - 99 mmHg ) stratified by absolute risk for primary prevention of CVD , but particularly in the low-risk ( < 10 % five-year absolute risk ) group . Methods R and omized trials of BP-lowering therapy versus placebo or pretreated subjects in active comparator studies with posttrial follow-up will be identified using a 2-step process . First , r and omized trials of BP-lowering therapy will be identified by ( 1 ) retrieving the references of trials included in published systematic review s of BP-lowering therapy , ( 2 ) retrieving studies published by the Blood Pressure Lowering Treatment Trialists ’ Collaboration ( BPLTTC ) , and ( 3 ) checking studies referenced in the 1993 World Health Organization/International Society of Hypertension meeting memor and um on BP management . Posttrial follow-up studies will then be identified by forward citation search ing the r and omized trials identified in step 1 through Web of Science . The search will include r and omized controlled trials with at least 1-year in-trial period and a posttrial follow-up phase . Age is the major determinant of absolute cardiovascular risk , so the participants in our review will be restricted to middle-aged adults who are more likely to have a lower cardiovascular risk profile . The primary outcome will be all-cause mortality . Secondary outcomes will include cardiovascular mortality , fatal stroke , fatal myocardial infa rct ion , and death due to heart failure . Results The search es for existing systematic review s and BPLTTC studies were piloted and modified . The study is expected to be completed before June 2018 . Conclusions The findings of this study will contribute to the body of knowledge concerning the beneficial , neutral , or harmful effects of delayed BP-lowering drug treatment on the primary prevention of CVD in patients with mildly elevated BP and low-to-moderate CVD risk . Trial Registration PROSPERO International Prospect i ve Register of Systematic Review s : CRD42017058414 ; https://www.crd.york.ac.uk/ PROSPERO /display_record.asp?ID = CRD42017058414 ( Archived by WebCite ® at http://www.webcitation.org/6t6sa8O2Q PURPOSE The objective of this study was to investigate the effects of exercise training and weight loss on blood pressure ( BP ) associated with physical activity and emotional stress during daily life . METHODS One hundred twelve participants with unmedicated high normal or stage 1 to stage 2 hypertension were r and omized to one of three conditions : a combined exercise and behavioral weight management group ( WM ) , an exercise-only group ( EX ) , or a wait list control group ( CON ) .  BP was assessed in the clinic and during 15 h of daytime ambulatory BP monitoring at baseline and after 6 months of treatment . RESULTS Increased levels of physical activity and emotional distress measured during daily life were associated with increases in systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate ( HR ) , and rate pressure product ( RPP ) . After treatment , the WM group had significantly lower DBP , HR , and RPP responses during both high and low levels of physical activity and emotional distress compared with the CON group . The EX group had similar BP levels as the WM group , although the EX group had significantly lower BP than the CON group during low but not high levels of physical activity and emotional distress . CONCLUSION These findings indicate that exercise , especially when combined with weight loss , reduces BP levels at rest and in situations that typically elevate BP such as intense physical activity and emotional distress PURPOSE The American College of Sports Medicine and the Centers for Disease Control and Prevention ( ACSM-CDC ) recommend 30 min of daily moderate-intensity physical activity for health ; however , the effectiveness of this recommendation in lowering blood pressure ( BP ) in hypertensives is unclear . The present study tested the hypothesis that walking activity following the ACSM-CDC physical activity recommendation would lower BP in postmenopausal women with high BP . METHODS Resting BP was measured in 24 postmenopausal women with borderline to stage 1 hypertension at baseline , 12 wk , and 24 wk . Fifteen women in the  exercise ( EX ) group walked 3 km.d-1 above their daily lifestyle walking , whereas 9 women in the control ( CON ) group did not change their activity . Walking activity was self-measured with a pedometer in both groups . RESULTS Resting systolic BP was reduced in the EX group after 12 wk by 6 mm Hg ( P < 0.005 ) and was further reduced by 5 mm Hg at the end of 24 wk ( P < 0.005 ) . There was no change in diastolic BP with walking . The CON group experienced no change in BP at either 12 or 24 wk . Body mass was modestly reduced by 1.3 kg in the EX group after 24 wk ( P < 0.05 ) ; however , it was not correlated with the change in BP . There were no changes in selected variables known to impact BP including percent body fat , fasting plasma insulin , or dietary intake . CONCLUSION In conclusion , a 24-wk walking program meeting the ACSM-CDC physical activity recommendation is effective in lowering systolic BP in postmenopausal women with borderline to stage 1 hypertension Physical activity has been shown to reduce colorectal cancer risk . However , the association of physical activity levels separately with colon and rectum cancer mortality is less clear . We included 226 089 Korean in a large prospect i ve cohort study . We assessed the associations of  physical activity levels ( length , frequency , and intensity ) with colon and rectum cancer mortality using Cox proportional hazards model . Men , but not women , who had regular physical activity showed a lower risk of death from colon cancer . The association for high intensity of physical activity  was borderline significant in men ( hazard ratio 0.67 ; 95 % CI = 0.45 - 1.00 for > 17.5 MET-hour/week ) . The associations were largely consistent among those aged < 55 years , body mass index < 25 kg/m2 , low high-density lipoprotein cholesterol , current smoker , and without hypertension or history of cardiovascular disease . In conclusion , higher length or intensity of physical activity  decreased colon , but not rectum cancer mortality in men .  Regular physical activity may have beneficial effects on colon cancer survival Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : OBJECTIVE A 2-year follow-up study of a cohort of 200 historically disadvantaged older South Africans was conducted to : ( i ) characterise current levels of habitual physical activity ; ( ii ) relate physical activity to current risk factors for chronic disease ; and ( iii ) identify risk factors associated with 2-year mortality . The baseline sample , drawn in 1993 , was found to have a high prevalence of hypertension ( 71.7 % ) . RESEARCH DESIGN Retrospective cohort study . METHODS A baseline sample of 200 persons aged > or = 65 years , resident in the Cape Peninsula , was r and omly drawn by means of a two-stage cluster design . Baseline measurements included : anthropometry , waist/hip ratio , systolic and diastolic blood pressure , body mass index ( BMI ) , serum albumin , serum ferritin , haemoglobin and fasting plasma glucose levels , plasma lipid profiles , oral glucose tolerance test and self-reported health status . Subjects were revisited after 2 years , at which time an adapted version of the Yale Physical Activity Survey was administered and measurements of blood pressure and anthropometry were repeated . STATISTICAL ANALYSES Spearman 's rank-order correlations were used to describe relationships between various current risk factors and physical activity . Logistic regression was used to determine predictors of 2-year mortality from baseline data . RESULTS At follow-up , 142 of the subjects ( 66 men , 76 women ) were traced and measurements collected . Thirty-two subjects were reported to have died by relatives living in the same household ( 22 men , 10 women ) . Levels of reported physical activity  in the survivors were two-thirds lower than those reported in a sample of North Americans of similar age . There was an inverse association between age and physical activity ( r = -0.31 ; P < 0.0005 ) and a positive association between BMI and physical activity ( r = 0.29 ; P < 0.005 ) . There was , however , no association between physical activity and systolic or diastolic blood pressure . In men , BMI in the lower tertile ( P = 0.07 ) and serum ferritin levels were positively associated with increased mortality . Serum albumin levels were protective over the 2-year follow-up period ( OR = 0.85 ; P < 0.05 ) . In women , being diabetic ( OR = 4.88 ; P = 0.06 ) and having a waist/hip ratio in the upper tertile ( OR = 3.26 ; P = 0.06 ) were associated with mortality . CONCLUSIONS Physical activity levels in this sample of older historically disadvantaged South Africans were habitually low . Simple anthropometric assessment s incorporating weight and waist/hip ratio , together with serum albumin measurements , may be useful to screen general health risk for older adults at primary care level and provide indications for social or medical intervention . Further , strategies for earlier detection and effective management of diabetes , particularly in older women , may reduce premature mortality in this population PURPOSE This study aim ed to establish whether time spent in sport-related physical activities and sedentary behaviors ( e.g. , TV viewing , videogame usage , and homework ) was prospect ively associated with change in blood pressure ( BP ) for 5 yr . METHODS Eight hundred and twenty-one students age 6 yr at baseline ( 397 girls and 424 boys ) were examined from 2003 - 2004 to 2009 - 2011 . Children completed detailed activity question naires . BP was measured using a st and ardized protocol . RESULTS After adjusting for age , ethnicity , parental education , parental history of hypertension , baseline height , BP , body mass index ( BMI ) , baseline time spent in corresponding activity behavior , and change in BMI , each hour per day spent in total screen time was associated with a 0.69 and 0.59 mm Hg increase in diastolic BP ( P = 0.01 ) and mean arterial BP ( P = 0.01 ) , respectively . In boys , each hour per day spent in TV viewing was associated with a concurrent 1.42-mm Hg increase in diastolic BP ( P = 0.04 ) during the 5 yr . Children engaging in low sport-related physical activities at baseline but who engaged in high levels of physical activity ( ≥ 60 min · d(-1 ) ) at follow-up ( n = 154 ) compared with those engaging in low sport-related physical activities at both examinations ( n = 305 ) demonstrated significantly lower mean arterial BP , 7.26 versus 9.61 mm Hg ( P = 0.04 ) . CONCLUSIONS Time spent in physical activity and screen time could influence BP measures during childhood Overweight and obesity have significant implication s during pregnancy and childbirth . The objective of this review was to provide a comprehensive overview of the effect of physical activity on pregnancy outcomes , the change of  physical activity during pregnancy , and women ’s perception of being physically active during pregnancy , with a particular focus on women who are overweight or obese . Many studies have investigated the beneficial effect of exercise during pregnancy , including reduced risk of gestational diabetes , preeclampsia , and operative birth , in addition to improved cardiovascular function , overall fitness , psychological well-being , and mood stability . Benefits for the infant include reduced risks of prematurity and improved fetal growth , although there is more limited information about longer-term health benefits for both women and infants . The existing literature examining physical activity patterns during pregnancy has generally focused on women of all body mass index categories , consistently indicating a reduction in activity over the course of pregnancy . However , the available literature evaluating physical activity during pregnancy among women who are overweight or obese is more limited and contradictory . A number of studies identified barriers preventing women from being active during pregnancy , including pregnancy symptoms , lack of time , access to child care , and concerns about their safety and that of their unborn baby . Conversely , significant enablers included positive psychological feelings , family influence , and receiving advice from health professionals . Very few studies have provided insights about perceptions of being active during pregnancy in the overweight and obese population . There is a need for a detailed description of physical activity patterns during pregnancy in women who are overweight or obese , and more r and omized trials evaluating exercise interventions for women who are overweight or obese , with a focus on clinical outcomes BACKGROUND Regular exercise has been associated in prospect i ve studies with reduced incidence of  cardiovascular disease ( CVD ) and death  . OBJECTIVE To assess in a cohort study whether there is a similar protective effect of regular exercise among hypertensive individuals . DESIGN Population -based prospect i ve cohort study . Spare time physical activity was assessed by structured interview . SETTING Malmo , Sweden . PARTICIPANTS Healthy men ( n = 642 ) born in 1914 . A baseline examination took place in 1969 - 1970 . MAIN OUTCOME MEASURES All-cause and cardiovascular mortality rates during 25 years of follow-up in relation to blood pressure and other risk factors for atherosclerosis . RESULTS One-hundred ( 16 % ) men reported vigorous spare time physical activity . In this group , 31 had hypertension ( blood pressure > 160/95 mm Hg or treatment for hypertension ) , 47 were smokers and 39 had hyperlipidaemia . Among the 173 men with hypertension , vigorous physical activity was associated with markedly reduced rates of all-cause ( 17.3 versus 40.0 deaths per 1000 person-years ) and cardiovascular mortality ( 6.3 versus 21.0 deaths per 1000 person-years ) . The risk reductions associated with exercise remained statistically significant after adjustment for smoking , systolic blood pressure and antihypertensive therapy . The relative risk was 0.43 ( confidence interval 0.22 - 0.82 ) for total mortality and 0.33 ( confidence interval 0.11 -0.94 ) for CVD mortality . CONCLUSION People who regularly perform physical activity constitute a heterogeneous group with regard to their exposure to known cardiovascular risk factors . Our results support the view that regular physical activity is associated with a reduced incidence of cardiovascular disease and death and suggest that this protective effect may be enhanced among hypertensive individuals Purpose Physical activity guidelines recommend at least 150 min of moderate-intensity physical activity ( MPA ) , 75 min of vigorous-intensity physical activity ( VPA ) , or combination of MPA and VPA . However , few epidemiological studies have examined whether the general population can derive equal health benefits from MPA or VPA . This study examined the associations of different activity intensities with mortality . Methods In this prospect i ve cohort study , a total of 83,454 community-dwelling Japanese who answered a question naire in 2000–2003 were followed for all-cause mortality through 2012 . Subjects were classified into four groups by physical activity guidelines and also by the proportion of VPA to total MVPA , that is , physically inactive , physically active without any VPA ( 0 % VPA ) , and active with some VPA ( 30 % or less ) or with more VPA ( more than 30 % ) . Hazard ratios of all-cause mortality were calculated with adjustment for potential confounders including physical activity volume . Results During 894,718 person-years of follow-up , 8891 deaths  were identified . Compared with physically inactive subjects , the adjusted hazard ratios for all-cause mortality were 0.75 ( 95 % confidence interval , 0.68–0.83 ) , 0.73 ( 0.65–0.82 ) , and 0.74 ( 0.62–0.89 ) among men , and 0.71 ( 0.62–0.81 ) , 0.75 ( 0.64–0.88 ) , and 0.74 ( 0.58–0.94 ) among women . For “ 0 % VPA , ” “ 30 % or less ” and “ more than 30 % , ” respectively . Conclusions Meeting the guidelines in either pattern of physical activity is important for lowering mortality risk . It may be suggested that people can receive comparable health benefit by MPA or VPA as long as they meet the guideline Elevated blood pressure ( BP ) during childhood and adolescence increases the risk of hypertension in later life . Although physical activity is known to positively moderate BP , data regarding this relationship are limited in prepubertal children . We aim ed to assess the association between a range of physical activities ( including indoor and outdoor activity ) and BP in a large community-based sample of prepubertal schoolchildren . Eligible year-1 schoolchildren ( n=1765 ; mean age 6.7±0.4 years ) from a r and om cluster sample of 34 schools in Sydney , Australia , were examined .  Parents completed detailed question naires about their child 's activity . Height and weight were measured , and body mass index  ( BMI ) was calculated . BP was measured using a st and ard protocol , and elevated BP was defined using published guidelines . Physical activity was classified as low , medium or high ( that is , as tertiles ) . After adjusting for age , sex , ethnicity , height , BMI , parental qualifications and family history of hypertension and /or cardiovascular disease , children in the highest tertile of outdoor and indoor activities had significantly lower diastolic BP ( ∼1.5 mm Hg ; Ptrend=0.01 ) and systolic BP ( ∼1.3 mm Hg ; Ptrend=0.03 ) , respectively , compared with those in the lowest tertile ( reference ) . Linearly , time spent in indoor activities ( each hour per day ) was associated with ∼2.4 mm Hg decrease in diastolic BP ( P=0.001 ) . Physical activity was independently associated with lower BP in this sample of prepubertal children . The findings emphasize the importance of ensuring regular physical activity programs in primary schools to potentially reduce the risk of elevated BP in childhood and in later life Background Hypertension is more prevalent and clinical ly severe among African – Americans than whites . Several health behaviors influence blood pressure ( BP ) control , but effective , accessible , culturally sensitive interventions that target multiple behaviors are lacking . Purpose We evaluated a culturally adapted , automated telephone system to help hypertensive , urban African – American adults improve their adherence to their antihypertensive medication regimen and to evidence -based guidelines for dietary behavior and physical activity . Methods We r and omized 337 hypertensive primary care patients to an 8-month automated , multi-behavior intervention or to an education-only control . Medication adherence , diet , physical activity , and BP  were assessed at baseline and every 4 months for 1 year . Data were analyzed using longitudinal modeling . Results The intervention was associated with improvements in a measure of overall diet quality ( + 3.5 points , p < 0.03 ) and in energy expenditure ( + 80 kcal/day , p < 0.03 ) . A decrease in systolic BP between groups was not statistically significant ( −2.3 mmHg , p = 0.25 ) . Conclusions Given their convenience , scalability , and ability to deliver tailored messages , automated telecommunications systems can promote self-management of diet and energy balance in urban African – Americans OBJECTIVE We previously demonstrated beneficial effects of physical activity on cardiovascular disease ( CVD ) risk factors , body mass index ( BMI ) and fat mass in  pre-pubescent obese children . The aim of this study was to determine whether these changes were maintained 2 years later . METHODS Two years after the R and omised Controlled Trial , we performed a follow-up study with 20 of 38 subjects ( 11.4 ± 1.8 years ) . Outcomes included blood pressure ( BP ) by ambulatory monitoring ; arterial function and structure using high-resolution ultrasound , BMI , body composition by dual-energy x-ray absorptiometry ( DXA ) , physical activity using accelerometer , and biological markers . RESULTS During the 2-year follow-up period , mean 24-hour diastolic BP z-score significantly decreased ( 1.4 ± 1.2 vs. 0.3 ± 1.4 , p = 0.04 ) , while systolic BP z-score was slightly reduced ( 2.4 ± 1.5 vs. 1.4 ± 1.7 , p = 0.067 ) . Blood pressure changes were greater in children who diminished their BMI z-score compared with the ones who did not . Systolic hypertension rates dropped from 50 to 28 % and diastolic hypertension from 42 to 6 % . In addition , arterial intima-media thickness ( 0.51 ± 0.03 vs. 0.51 ± 0.06 , p = 0.79 ) , BMI z-score ( 2.9 ± 0.8 vs. 2.9 ± 1.1 kg.cm(-2 ) , p = 0.27 ) , body fat ( 41.9 ± 6.9 vs. 42.8 ± 6.7 % ; p = 0.39 ) and physical activity count ( 703 ± 209 vs. 574 ± 244 cpm , p = 0.30 ) were stable . CONCLUSION To our knowledge , this is the first study reporting that beneficial effects on adiposity and CVD risk factors of a physical activity centred intervention are sustained 2 years after the cessation of training in obese children . Subjects stabilized BMI z-score and maintained physical activity with further improvement of BP and stabilization of arterial wall remodelling . We conclude that it is important to encourage physical activity in this population . Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children : A R and omised Controlled Trial : NCT00801645 Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life Background Health promotion is a key component for primary prevention of cardiovascular disease ( CVD ) . This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors ( CVDRF )  in the general population in the context of a community-based programme on hypertension management . Methods A quasi-experimental intervention study was carried out in two rural communes of Vietnam from 2006 to 2009 . In the intervention commune , a hypertensive-targeted management programme integrated with a community-targeted health promotion was initiated , while no new programme , apart from conventional healthcare services , was provided in the reference commune . Health promotion campaigns focused on smoking cessation , reducing alcohol consumption , encouraging physical activity and reducing salty diets . Repeated cross-sectional surveys in local adult population aged 25 years and over were undertaken to assess changes in blood pressure ( BP ) and behavioural CVDRFs ( smoking , alcohol consumption , physical inactivity and salty diet ) in both communes before and after the 3-year intervention . Results Overall 4,650 adults above 25 years old were surveyed , in four r and omly independent sample s covering both communes at baseline and after the 3-year intervention . Although physical inactivity and obesity increased over time in the intervention commune , there was a significant reduction in systolic and diastolic BP ( 3.3 and 4.7 mmHg in women versus 3.0 and 4.6 mmHg in men respectively ) in the general population at the intervention commune . Health promotion reduced levels of salty diets but had insignificant impact on the prevalence of daily smoking or heavy alcohol consumption . Conclusion Community-targeted healthy lifestyle promotion can significantly improve some CVDRFs in the general population in a rural area over a relatively short time span . Limited effects on a context -bound CVDRF like smoking suggested that higher intensity of intervention , a supportive environment or a gender approach are required to maximize the effectiveness and maintain the sustainability of the health intervention Background : Lifestyle factors such as weight , salt intake , and physical activity have shown to be important in treating hypertension . The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure ( BP ) of Iranian women . Material s and Methods : This r and omized controlled trial was conducted in four health centers by recruiting 161 women aged 35 - 65 years with high BP and r and omizing them to a 4-week lifestyle modification ( n = 80 ) or control group ( n = 81 ) . BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months . Results : The mean systolic BP changed from 158.8 ( ±8.1 ) mmHg to 153.2 ( ±6.4 ) mmHg during 4-week and to 145.5 ( ±4.6 ) ) mmHg after 6 months in the intervention group ( P < 0.001 ) . There was a significant difference between two groups of study after 4-week mean = 5.6 ( confidence interval [ CI ] = 5.1 - 6.6 ) and 6 months follow mean ( CI = 12.3 - 14.6).(P < 0.001 ) A significant correlation was detected between systolic BP ( SBP ) and diastolic BP ( DBP ) with weight , body mass index , waist circumference , salt intake , and physical activity level ( P < 0.001 ) . Stepwise regression analyses indicated that the weight , dietary salt intake , and physical activity level were significant predictors of SBP and DBP . Conclusion : The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women PURPOSE To examine the effect of resistance exercises on self-reported physical function and activities of daily living ( ADL ) in older adults with osteoporosis or osteopenia . METHODS A search of available literature was conducted using PubMed , CINAHL , SPORTD iscus , PEDro , ProQuest Nursing and Allied Health Source , and Cochrane Controlled Trials Register . Studies were included if they involved ( 1 ) r and omized controlled trials ; ( 2 ) participants with osteoporosis or osteopenia ; ( 3 ) resistance exercise as an intervention ;  and ( 4 ) self-report of physical function or ADL . Articles were independently review ed for quality by two authors using the Physiotherapy Evidence Data base ( PEDro ) scale . Cohen 's d effect size was calculated by dividing st and ardized mean differences by the st and ard deviation to determine treatment effect in terms of physical function or ADL . RESULTS Five full-text articles were selected for inclusion . PEDro scores ranged from 5 to 7 ( out of 10 ) . Effect size mean differences as a result of resistance intervention ranged from 0.08 to 1.74 , suggesting " trivial " to " large " effects on self-reported physical function and ADL . CONCLUSION RESULTS suggest that interventions using resistance training have a beneficial impact on the domains of physical function and ADL in participants with osteoporosis or osteopenia . More high- quality studies are needed to lend further validity to this supposition Abstract Objective To assess the prospect i ve associations of baseline and long term trajectories of physical activity on mortality from all causes , cardiovascular disease , and cancer . Design Population based cohort study . Setting Adults from the general population in the UK . Participants 14 599 men and women ( aged 40 to 79 ) from the European Prospect i ve Investigation into Cancer and Nutrition-Norfolk cohort , assessed at baseline ( 1993 to 1997 ) up to 2004 for lifestyle and other risk factors ; then followed to 2016 for mortality ( median of 12.5 years of follow-up , after the last exposure assessment ) . Main exposure  Physical activity energy expenditure ( PAEE ) derived from question naires , calibrated against combined movement and heart rate monitoring . Main outcome measures Mortality from all causes , cardiovascular disease , and cancer . Multivariable proportional hazards regression models were adjusted for age , sex , sociodemographics , and changes in medical history , overall diet quality , body mass index , blood pressure , triglycerides , and cholesterol levels . Results During 171 277 person years of follow-up , 3148 deaths occurred . Long term increases in PAEE were inversely associated with mortality , independent of baseline PAEE . For each 1 kJ/kg/day per year increase in PAEE ( equivalent to a trajectory of being inactive at baseline and gradually , over five years , meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity ) , hazard ratios were : 0.76 ( 95 % confidence interval 0.71 to 0.82 ) for all cause mortality , 0.71 ( 0.62 to 0.82 ) for cardiovascular disease mortality , and 0.89 ( 0.79 to 0.99 ) for cancer mortality , adjusted for baseline PAEE , and established risk factors . Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer . Joint analyses with baseline and trajectories of physical activity show that , compared with consistently inactive individuals , those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes , with hazard ratios of 0.76 ( 0.65 to 0.88 ) , 0.62 ( 0.53 to 0.72 ) , and 0.58 ( 0.43 to 0.78 ) at low , medium , and high baseline physical activity , respectively . At the population level , meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46 % of deaths associated with physical inactivity . Conclusions Middle aged and older adults , including those with cardiovascular disease and cancer , can gain substantial longevity benefits by becoming more physically active , irrespective of past physical activity levels and established risk factors . Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life OBJECTIVE The aim of this study was to examine both single and joint associations of physical activity and conventional cardiovascular risk factors with total and cardiovascular mortality among patients with diabetes . RESEARCH DESIGN AND METHODS We prospect ively followed 3,708 Finnish patients with type 2 diabetes aged 25 - 74 years .  Physical activity , smoking status , blood pressure , height , weight , and serum cholesterol level were determined at baseline . Cox proportional hazard models were used to estimate single and joint effects of physical activity and other cardiovascular risk factors on the risk of mortality . RESULTS During a mean follow-up of 18.7 years , 1,423 deaths were recorded , 906 of which were due to cardiovascular disease . Moderate or high levels of physical activity were associated with decreased total and cardiovascular mortality , whereas higher levels of BMI and blood pressure and current smoking were associated with increased total and cardiovascular mortality . High serum cholesterol levels also increased cardiovascular mortality . The protective effect of physical activity was consistent in diabetic patients with any levels of BMI , blood pressure , total cholesterol , and smoking . CONCLUSIONS A moderate or high level of physical activity was associated with a reduced risk of total and cardiovascular mortality among patients with type 2 diabetes . The favorable association of physical activity with longevity was observed regardless of the levels of BMI , blood pressure , total cholesterol , and smoking Objective There is a lack of evidence to show the role of exercise intensity in the prevention of cancer mortality because no previous studies have shown this relation . The relationship of leisure-time physical activity with cancer mortality was therefore assessed . Methods Participants were from a population -based sample of 2560 men from eastern Finl and with no history of cancer at baseline .  Physical activity was assessed using the 12-month leisure-time physical activity question naire . During an average follow-up of 16.7 years , a total of 181 cancer related deaths occurred . Results An increase of 1.2 metabolic units ( MET or metabolic equivalents of oxygen consumption ; 1 SD in metabolic equivalents ) in the mean intensity of  leisure-time physical activity  was related to a decrease ( relative risk ( RR ) 0.85 , 95 % CI 0.72 to 0.99 ) in cancer mortality mainly due to lung and gastrointestinal cancers , after adjustment for age , examination year , alcohol consumption , smoking , body mass index and energy , fibre and fat intake . Men with leisure-time physical activity of more than 5.2 MET ( highest quartile ) had a lower ( RR 0.63 , 95 % CI 0.40 to 0.99 ) cancer mortality compared with men whose mean intensity of physical activity was less than 3.7 MET ( lowest quartile ) . The mean intensity of physical activity  was related to the risk of cancer death among men who exercised at least 30 minutes per day on average . Conclusions This prospect i ve study indicates that the mean intensity of leisure-time physical activity is inversely associated with the risk of premature death from cancer in men The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer . Relevant studies were identified by entering the following search terms into Pubmed : aerobic training ; resistance training ; stretching ; pediatric ; children ; AND cancer . Reference lists in retrieved manuscripts were also review ed to identify additional trials . We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses . Nine included children with an acute lymphoblastic leukemia ( ALL ) diagnosis , and six children with mixed cancer diagnoses . Generally , interventions tested were either in-hospital supervised exercise training or home based programs design ed to promote physical activity . Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness , improved muscle strength and flexibility , reduced fatigue and improved physical function . Generalizations to the entire childhood cancer and childhood cancer survivor population s are difficult as most of the work has been done in children during treatment for and among survivors of ALL . Additional r and omized studies are needed to confirm these benefits in larger population s of children with ALL , and in population s with cancer diagnoses other than ALL
Regular physical activity is beneficial for reducing mortality in patients with high BP .
BACKGROUND Physical activity has been shown to be beneficial for the prevention and management of hypertension .
In the general population , physical activity has been shown to decrease mortality .
PURPOSE The purpose of this systematic review was to identify and synthesize the literature examining the impact of physical activity on mortality in patients with high blood pressure ( BP ) .