Blood pressure and BMI in adolescents in Aracaju, Brazil. Blood pressure and related cardiovascular disease risk factors in 6-18 year-old students in Italy. Does exercise intensity affect blood pressure and heart rate in obese adolescents? A 6-month multidisciplinary randomized intervention study. Association between physical activity and blood pressure in prepubertal children Effect of changes in BMI and waist circumference on ambulatory blood pressure in obese children and adolescents Blood pressure and associated factors in a North African adolescent population. a national cross-sectional study in Tunisia The efficacy and safety of valsartan in obese and non-obese pediatric hypertensive patients. Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs Blood pressure in obese adolescents: effect of weight loss. Maternal Energy Stores and Diet Composition During Pregnancy Program Adolescent Blood Pressure [Arterial prehypertension and elevated pulse pressure in adolescents: prevalence and associated factors]. Effects of exercise and weight loss on blood pressure during daily life. Relationship between resting blood pressure and laboratory-induced pain among healthy children. Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children. Cross-sectional and longitudinal associations between physical activity and blood pressure in adolescence: birth cohort study. Long-term follow-up of cardiovascular risk factors after exercise training in obese children. DASH Diet Lowers Blood Pressure and Lipid-Induced Oxidative Stress in Obesity Trimester-specific blood pressure levels in relation to maternal pre-pregnancy body mass index. Changes in BMI and blood pressure after a school based intervention: the CHILDREN study. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age BLOOD PRESSURE IN CHILDREN AND ADOLESCENTS Comprehensive lifestyle modification and blood pressure control: a review of the PREMIER trial. Uric Acid Reduction Rectifies Prehypertension in Obese Adolescents
OBJECTIVE To assess the prevalence of high blood pressure ( BP ) and the association of overweight and obesity with  high BP among adolescents in Aracaju , Brazil . DESIGN Cross-sectional study . The main outcome measure was the proportion of adolescents with high BP ( sex- , age- and height-specific ≥ 95th percentile ) . The main predictor variables were overweight and obesity defined according to the criteria of the International Obesity Task Force . Other covariates included age , socio-economic status and leisure-time physical activity . SETTING Aracaju , Brazil , capital city of Sergipe State , north-eastern Brazil . SUBJECTS A r and om sample of 1002 adolescents ( 442 boys and 560 girls ) aged 12 - 17 years selected from twenty public schools and ten private schools were studied . RESULTS The prevalence of high BP was 16.9 % ( 95 % CI 13.1 , 21.7 ) in boys and 12.9 % ( 95 % CI 9.0 , 18.0 ) in girls . After adjusting for age , socio-economic status and leisure-time physical activity in both boys and girls , overweight ( prevalence ratio ( PR ) = 1.93 , 95 % CI 1.08 , 3.48 ; PR = 4.34 , 95 % CI 2.58 , 7.30 , respectively ) and obesity ( PR = 4.87 , 95 % CI 2.35 , 10.11 ; PR = 5.18 , 95 % CI 2.67 , 10.06 , respectively ) were found to be associated with high BP . CONCLUSIONS These findings indicate a high prevalence of high BP in both boys and girls in Aracaju , Brazil . Overweight and obesity were strongly associated with high BP . These findings underscore the urgent need for public health measures to prevent increasing high BP  in adolescents in Brazil .  Targeting intervention in adolescence may be a critical method for preventing high BP in later life OBJECTIVES The aims of this study were to provide data on blood pressure ( BP ) levels , to measure prevalence of high-normal or high BP and to identify a set of conditions that may predict high BP ( HBP ) in a population of children and adolescents in Italy . METHODS A r and om sample of students 6 - 18 years old attending r and omly selected schools in Catanzaro , Italy , was recruited . All students completed a question naire on their health and on health behaviours , such as physical activity , diet , drinking and smoking . Blood pressure , heart rate , height , weight and body mass index ( BMI ) were recorded . RESULTS Of the 603 subjects examined , 12.8 % had high-normal BP , 3.5 % hypertension ( HTN ) and 11.1 % were obese . High-normal or high diastolic BP ( DBP ) was significantly more likely in older subjects with a higher BMI , in those with a smoker mother and in preterm children , whereas high-normal or high systolic BP ( SBP ) was significantly more likely to be found in older subjects with a higher BMI and in those who had at least one parent with HTN . High-normal or high DBP or SBP were significantly predicted by BMI and age . CONCLUSIONS Interventions should focus at reducing obesity and encouraging proper dietary habits , sufficient exercise and cessation of smoking habit in parents too , especially in children with a family history of HTN BACKGROUND Aerobic exercise improves cardiovascular health in general , but whether the impact varies with exercise intensity is not clear . OBJECTIVE The aim of the current study was to compare the effects of a high-intensity aerobic exercise training ( HIT ) vs. a low-intensity aerobic exercise training ( LIT ) on blood pressure ( BP ) , heart rate ( HR ) and heart rate variability ( HRV ) in obese adolescents . METHODS Forty-three ( 13 - 18 years ) Tanner stage ( III-IV ) matched obese adolescents were studied in a r and omized trial of either HIT ( corresponding to the ventilatory threshold I ; n = 20 ) or LIT ( corresponding to 20 % below the ventilatory threshold I ; n = 23 ) programme for a period of 6 months . All participants also received a multidisciplinary therapy that included nutritional , psychological and clinical counselling . Both HIT and LIT sessions were isocaloric , with energy expenditure set at 350 kcal . BP , HR and HRV were measured along with markers of body adiposity and insulin resistance before and after the respective interventions . RESULTS The participants in both groups had similar physical and clinical characteristics . After the 6-month intervention , systolic , diastolic and mean BP decreased ( P < 0.05 , for all ) similarly in both groups , whereas waist circumference , HR and HRV showed beneficial changes only in the HIT group ( P < 0.05 ) . CONCLUSION Aerobic exercise training set at a high intensity compared with the low intensity appears to have additional benefits on abdominal obesity and cardiovascular health in that it enhances the parasympathetic and autonomic modulation of the heart in obese adolescents 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 : Weight reduction has been accompanied with a reduction in clinic blood pressure ( BP )  in children and adolescents ; however , the effect on ambulatory BP ( ABP ) is uncertain . The objective was to investigate the impact of weight changes on ABP in obese children and adolescents . Methods : Sixty-one severely obese patients aged 10–18 years underwent lifestyle intervention at the Children 's Obesity Clinic . Patients were examined with  ABP monitoring  at baseline and after 1 year of treatment ( follow-up ) . To account for growth , BP and BMI were st and ardized into z scores , whereas waist circumference was indexed by height [ waist/height ratio ( WHR ) ] . Results : Patients experienced a reduction at follow-up in the degree of obesity [ & Dgr ; BMI z score : −0.21 , 95 % confidence interval ( CI ) −0.32 to −0.10 , P = 0.0003 ; and & Dgr;WHR : −0.02 , 95 % CI −0.03 to −0.004 , P = 0.009 ] . & Dgr;24-h , & Dgr;daytime and & Dgr;night-time SBP and DBP in mmHg and changes in equivalent z scores were related to & Dgr ; BMI z scores and & Dgr;WHR . These relationships were reproduced in multiple regression analyses adjusted for relevant confounders , for example , a reduction in one BMI z score corresponds to a reduction in 24-h SBP by 6.5 mmHg ( P < 0.05 ) . No relationship was found between changes in these anthropometric obesity measures and changes in clinic BP . Conclusion : Changes in obesity measures were closely related to changes in ABP , but not to changes in clinic BP , in severe obese children and adolescents after 1 year of lifestyle intervention . The findings emphasize the use of 24-h ABP measurements in children and adolescents Background In southern and eastern Mediterranean countries , changes in lifestyle and the increasing prevalence of excess weight in childhood are risk factors for high blood pressure ( BP ) during adolescence and adulthood . The aim of this study was to evaluate the BP status of Tunisian adolescents and to identify associated factors . Methods A cross-sectional study in 2005 , based on a national , stratified , r and om cluster sample of 1294 boys and 1576 girls aged 15 - 19 surveyed in home visits . The socio-economic and behavioral characteristics of the adolescents were recorded . Overweight/obesity were assessed by Body Mass Index ( BMI ) from measured height and weight ( WHO , 2007 ) , abdominal obesity by waist circumference ( WC ) . BP was measured twice during the same visit  . Elevated BP was systolic ( SBP ) or diastolic blood pressure ( DBP ) ≥ 90th of the international reference or ≥ 120/80 mm Hg for 15 - 17 y. , and SBP/DBP ≥ 120/80 mm Hg for 18 - 19 y. ; hypertension was SBP/DBP ≥ 95th for 15 - 17 y. and ≥ 140/90 mm Hg for 18 - 19 y. Adjusted associations were assessed by logistic regression . Results The prevalence of elevated BP was 35.1%[32.9 - 37.4 ] : higher among boys ( 46.1 % vs. 33.3 % ; P < 0.0001 ) ; 4.7%[3.8 - 5.9 ] of adolescents had hypertension . Associations adjusted for all covariates showed independent relationships with BMI and WC : - obesity vs. no excess weight increased elevated BP ( boys OR = 2.1[1.0 - 4.2 ] , girls OR = 2.3[1.3 - 3.9 ] ) and hypertension ( boys OR = 3.5[1.4 - 8.9 ] , girls OR = 5.4[2.2 - 13.4 ] ) , - abdominal obesity ( WC ) was also associated with elevated BP in both genders ( for boys : 2nd vs. 1st tertile OR = 1.7[1.3 - 2.3 ] , 3rd vs.1st tertile OR = 2.8[1.9 - 4.2 ] ; for girls : 2nd vs. 1st tertile OR = 1.6[1.2 - 2.1 ] , 3rd vs.1st tertile OR = 2.1[1.5 - 3.0 ] ) but only among boys for hypertension . Associations with other covariates were weaker : for boys , hypertension increased somewhat with sedentary lifestyle , while elevated BP was slightly more prevalent among urban girls and those not attending school . Conclusion Within the limits of BP measurement on one visit only , these results suggest that Tunisian adolescents of both genders are likely not spared from early elevated BP . Though further assessment is likely needed , the strong association with overweight/obesity observed suggests that interventions aim ed at changing lifestyles to reduce this main risk factor may also be appropriate for the prevention of elevated BP This post hoc analysis assessed the efficacy and tolerability of valsartan for the treatment of hypertension in obese vs non-obese children and adolescents . After a 1-week antihypertensive washout period , 142 obese and 119 non-obese hypertensive children and adolescents aged 6 to 16 years were r and omized to 2 weeks of once-daily treatment with valsartan 10 to 20 mg , 40 to 80 mg , or 80 to 160 mg , followed by re-r and omization to either valsartan or placebo for an additional 2 weeks . Patients could continue to receive valsartan during an optional 52-week , open-label extension . Valsartan result ed in statistically significant ( P<.05 ) and clinical ly relevant reductions in mean sitting blood pressure ( BP ) , ranging from approximately 7/4 mm Hg ( valsartan 10 - 20 mg ) to 13/9 mm Hg ( valsartan 80 - 160 mg ) in both obese and non-obese patients . BP control was achieved in 44 % of obese and 56 % of non-obese patients . Following re-r and omization , non-obese patients experienced an increase in BP during placebo treatment , albeit levels remained below baseline , whereas BP reductions were maintained in valsartan recipients ( P<.05 ) . The most frequent adverse events during the open-label phase were headache and fever .  Valsartan provides similar antihypertensive efficacy in obese and non-obese hypertensive children and adolescents , with good tolerability in both patient population Objective : To assess the effect of a lifestyle intervention in lowering/normalizing blood pressure ( BP ) levels in hypertensive ( controlled or not ) obese patients . Methods : In this prospect i ve observational study , 490 obese hypertensive patients , 389 controlled ( BP < 140/90 mm Hg ; CH ) and 101 uncontrolled ( BP ≥ 140/90 mm Hg ; UH ) attended a 3-month lifestyle intervention .  Before and after the intervention we assessed weight , waist circumference , fat mass , BP , metabolic and renal variables , and physical activity . A multivariate regression model was used to determine the predictors of BP changes . Results : 18.9 % of CH and 20.0 % of UH were on ≥ 3 antihypertensive drugs . Weight change ( average -4.9 ± 2.7 % ) was independent of the antihypertensive drugs employed . Systolic BP ( SBP ) decreased by 23 mm Hg and diastolic BP ( DBP ) by 9 mm Hg , in patients with UH most of whom ( 89 % ) normalized BP levels ( in 49 % after a weight loss < 5 % ) . Age , gender , whole and central obesity , concomitance of type 2 diabetes , chronic renal disease , physical activity intensification , and pharmacological therapy did not affect BP lowering . In the regression analysis with SBP change as dependent variable , weight reduction ( β = 0.523 , p = 0.005 ) and group ( UH vs. CH , β = -19.40 , p = 0.0005 ) remained associated with SBP reduction . When DBP change was entered as dependent variable , baseline uric acid remained associated with DBP reduction ( β = 0.824 , p < 0.05 ) . Conclusion : Lifestyle interventions are useful for all obese hypertensive patients in most of whom a modest weight loss is sufficient to normalize BP levels avoiding the aggressive use of multiple antihypertensive drugs The BP distribution of a group of 72 obese adolescents was determined both before and after weight loss . Weight loss was produced by a program of caloric restriction and behavior change alone ( n = 26 ) or with a combination of caloric restriction , behavior change , and exercise ( n = 25 ) . It was demonstrated that obese adolescents have a BP distribution that is skewed 1 SD to the right of normal ( P less than .01 ) , and that with weight loss this distribution was no longer different from that of the general population . It was also shown that a weight loss program that incorporates exercise and caloric restriction produces the most desirable effect on BP reduction ( ie , greatest decrease in resting systolic BP and greatest decrease in exercise diastolic and mean BP ) . Finally , it was demonstrated that obese adolescents have structural changes present in the forearm resistance vessels and that these structural changes are reversed to the greatest extent in the weight loss program that includes exercise Background —Fetal undernutrition is hypothesized to program blood pressure ( BP ) later in life . Human epidemiological studies that use birth weight as a proxy for fetal malnutrition fail to identify specific aspects of maternal nutrition responsible for programming . Methods and Results —We examined how maternal nutrition during pregnancy and infant birth weight relate to systolic and diastolic BP ( SBP and DBP ) in 2026 Filipino adolescents . Data were collected prospect ively during the Cebu ( Philippines ) Longitudinal Health and Nutrition Survey . Women were assessed at ≈30 weeks gestation , and children were followed from birth through adolescence . Regression models were used to examine how the mothers ’ total energy intake , percentage of energy from protein and fat , triceps skinfold thickness during pregnancy , and infant birth weight relate to adolescent BP , controlling for current age , height , and body mass index and other potential confounders . Maternal triceps skinfold thickness was significantly inversely related to SBP among boys and to DBP in boys and girls . Maternal nutrition variables attenuated but did not eliminate an inverse birth weight – SBP relationship in boys . SBP was significantly inversely related to the mothers ’ percent of dietary energy from protein in boys . Among girls , SBP and DBP were inversely related to the mothers ’ percentage of calories from fat . There was no evidence of confounding of these relationships by current diet , maturation status , physical activity , or socioeconomic status . Conclusions —Maternal diet composition and energy stores in the form of subcutaneous fat have long-term effects on offspring BP in adolescence OBJECTIVE To estimate the prevalence of prehypertension and elevated pulse pressure in adolescents and assess the association between those two conditions and sex , age , sexual development , obesity and physical activity . METHODS  Anthropometrical data and blood pressure were measured in and a question naire was applied to 456 adolescents ( aged 12 to 17 years ) recruited from public and private schools , in the Fonseca district , in the city of Niterói , state of Rio de Janeiro , Brazil , from 2003 to 2004 . RESULTS Thirty nine ( 8.6 % ) presented prehypertension ( PH ) and 13.4 % , elevated pulse pressure ( PP ) . At bivariate analysis , PH was significantly associated with sex , age and obesity , with more prevalent in boys aged between 15 and 17 years , and in the obese . Elevated PP was associated with gender only , as it was more prevalent in boys . Sexual maturation did not show an association with PH or elevated PP . Similar correlations were found at logistic regression . PH prevalence odds ratio was 7.7 for sex , 4.3 for age and 4.6 for obesity . Elevated PP prevalence odds ratio was 10.8 for sex . The correlation between PP and physical activity was positive and significant . The elevation of PP was attributable to systolic blood pressure . CONCLUSION PH and the elevated PP were shown to be present in adolescents from a population with a low prevalence of hypertension , mostly in boys . Further prospect i ve studies are necessary to assess the persistence and the impact of those conditions 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 BACKGROUND Adult studies have demonstrated that increased resting blood pressure ( BP ) levels correlate with decreased pain sensitivity . However , few studies have examined the relationship between BP and experimental pain  sensitivity among children . OBJECTIVES This study investigated the association between resting BP levels and experimental pain tolerance , intensity , and unpleasantness in healthy children . We also explored whether these BP-pain relationships were age and gender dependent . METHODS Participants underwent separate 4-trial blocks of cutaneous pressure and thermal pain stimuli , and 1 trial of a cold pain stimulus in counterbalanced order . RESULTS A total of 235 healthy children ( 49.6 % female ; mean age 12.7 [ 2.9 ] years ; age range 8 - 18 years ) participated . The study revealed specific gender-based BP-pain relationships .  Girls with higher resting systolic BP levels were found to have lower thermal intensity ratings than girls with lower resting systolic BP levels ; this relationship was stronger among adolescent girls than among younger girls . Among young girls ( 8 - 11 years ) , those with higher resting diastolic BP ( DBP ) levels were found to have lower cold intensity and unpleasantness as well as lower thermal intensity ratings than did young girls with lower resting DBP levels ; these DBP-pain response relationships were not seen among adolescent girls . CONCLUSIONS Age , rather than resting BP , was predictive of laboratory pain ratings in boys . The findings suggest that the relationship between BP and experimental pain is age and gender dependent . These aspects of cardiovascular relationships to pain in males and females need further attention to underst and their clinical importance 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 r and omized controlled trial with a modified crossover design : 44 pre-pubertal obese children ( age 8.9 + or - 1.5 years ) were r and omly 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 st and ard 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 R and omized Controlled Trial ; NCT00801645 ) OBJECTIVES To explore cross-sectional and longitudinal associations between self-reported and accelerometry-based physical activity ( PA ) and blood pressure ( BP ) between 11 and 14 years of age . METHODS Prospect i ve birth cohort study in Pelotas , Brazil . Participants were 427 cohort members who were followed up with at 11 , 12 , and 14 years of age , and had question naire data on PA and BP at 11 and 14 years , as well as accelerometry and question naire data on PA at 12 years . Outcome measures were continuous systolic and diastolic BP at 14 years , and change in BP from 11 to 14 years . RESULTS PA was unrelated to systolic BP in any analyses . PA measured by accelerometry at 12 years , but not question naire-derived PA , was inversely associated with diastolic BP at 14 years of age in fully adjusted models . Those who exceeded the 300-minutes PA threshold at all 3 visits had a 2.6 mmHg lower mean increase in DBP from 11 to 14 years compared with those classified below the threshold in all visits . CONCLUSIONS Accelerometry-based PA was longitudinally inversely associated with  diastolic BP . This finding was not evident when analyzing self-reported PA at a given age , suggesting a possible underestimation of the association when using subjective data 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 Abstract — Evidence suggests that obesity may raise blood pressure ( BP ) through oxidative stress – sensitive mechanisms and that the Dietary Approaches to Stop Hypertension combination diet ( DASH-CD ) may decrease BP by enhancing antioxidant capacity . To address this question , 12 obese patients with high-normal – to – stage 1 hypertension ( hypertensives ) and 12 lean normotensives were studied on their usual diets and after following the DASH-CD and a low-antioxidant diet in r and om sequence for 4 weeks each . Acute oxidative stress was induced by a 4-hour infusion of intralipid and heparin  . Ferric-reducing activity of plasma ( FRAP ) and plasma F2-isoprostanes were measured as biomarkers of antioxidant capacity and oxidative stress , respectively . BP was lower in obese hypertensives on the DASH-CD than on the usual and low-antioxidant diets ( −8.1±1.5/−7.4±1.6 mm Hg , P < 0.05 ) . BP did not change significantly in lean normotensives after 4 weeks on the DASH-CD but tended to rise on the low-antioxidant diet  . FRAP on usual diets was higher in lean subjects than in obese subjects . FRAP increased in obese but not lean volunteers on the DASH-CD compared with usual diet , and the group difference disappeared . F2-isoprostanes increased from baseline during intralipid and heparin in both groups on the low-antioxidant diet but not in obese hypertensives on the DASH-CD . Among free-living obese hypertensives , the DASH-CD  raises antioxidant capacity , lowers BP , and reduces oxidative stress induced by acute hyperlipidemia . The findings are consistent with evidence that elevated BP in obese subjects may reflect an imbalance between antioxidant capacity and oxidative stress that is improved by the DASH-CD We evaluated the influence of maternal pre-pregnancy body mass index ( BMI ) , based on reported pre-pregnancy weight and height , on blood pressure ( BP ) levels during pregnancy by using information from a prospect i ve cohort of 1733 women recruited before 20 weeks ' gestation . Maternal antenatal BP values were abstract ed from medical records , and we evaluated the mean BP differences according to BMI group in regression models , using generalised estimating equations to account for repeated BP records within each pregnancy . In each trimester , mean systolic BP ( SBP ) and diastolic BP ( DBP ) values were positively associated with maternal pre-gestational BMI . This association persisted after adjustment for maternal age , parity , smoking , education , marital status and physical activity . Overweight women ( 25 - 29 kg/m(2 ) ) had first- , second- and third-trimester mean SBPs that were 8.1 , 7.7 and 8.2 mmHg , respectively , higher than values observed in lean women ( < 20 kg/m(2 ) ) . Mean DBP values were 4.5 , 5.4 and 5.6 mmHg higher for each successive trimester in overweight vs. lean women . Obese ( > 30 kg/m(2 ) ) women consistently had the highest mean SBP and DBP values . Trimester-specific mean SBP values were 10.7 - 12.0 mmHg higher among obese women vs. lean women . Corresponding trimester-specific mean DBP values were 6.9 - 7.4 mmHg higher in obese vs. lean women . Similar patterns were observed when trimester-specific average mean arterial pressures were evaluated . Elevated pregnancy BPs associated with maternal pre-gestational BMI are consistent with a large body of literature that documents increased pre-eclampsia risk among overweight and obese women BACKGROUND Identification of the behavioural , normative and control beliefs influencing children 's behaviour is an important prerequisite in design ing effective interventions . The current study aims to evaluate the effectiveness of an intervention program , based on the Theory of Planned Behaviour ( TPB ) , on  obesity indices and blood pressure ( BP ) in Ioannina , Greece . METHODS Participants were 646 fifth grade pupils ( 360 girls and 286 boys ) . The intervention group ( IG ) consisted of 321 children in 13 r and omly selected schools while the rest ( n = 325 children ) served as the  control group ( CG ) . Based on the outcome of the TPB question naire , the intervention focused on overcoming the barriers in accessing physical activity areas , increasing the availability of fruits and vegetables and increasing parental support . General linear mixed model and mediating variable analysis were used to evaluate the differences between the two groups and to test whether changes in certain dietary , physical activity and anthropometrical indices mediated the effect of the intervention on BP . RESULTS IG had higher consumption of fruits and lower consumption of fats/oils and sweets/beverages compared with the CG . Intervention 's effect on BMI could be explained by the changes in fruit and fats/oils intake whereas the reduction of systolic and diastolic BP could be explained by the reduction of BMI . CONCLUSIONS The findings indicate favourable changes in BP and obesity indices after the implementation of a 1-year school-based intervention program based on the TPB . These results highlight the importance of developing a social and physical environment that promotes balanced eating behaviours and extra-curricular access to physical activity venues Recommendations for control of high blood pressure ( BP ) emphasize lifestyle modification , including weight loss , reduced sodium intake , increased physical activity , and limited alcohol consumption . The Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern also lowers BP . The PREMIER r and omized trial tested multicomponent lifestyle interventions on BP in demographic and clinical subgroups . Participants with above-optimal BP through stage 1 hypertension were r and omized to an Advice Only group or one of two behavioural interventions that implement established recommendations ( Est ) or established recommendations plus DASH diet ( Est plus DASH ) . The primary outcome was change in systolic BP at 6 months . The study population was 810 individuals with an average age of 50 years , 62 % women , 34 % African American ( AA ) , 95 % overweight/obese , and 38 % hypertensive . Participants in all the three groups made lifestyle changes . Mean net reductions in systolic ( S ) BP in the Est intervention were 1.2 mmHg in AA women , 6.0 in AA men , 4.5 in non-AA women , and 4.2 in non-AA men . The mean effects of the  Est Plus DASH intervention were 2.1 , 4.6 , 4.2 , and 5.7 mmHg in the four race – sex subgroups , respectively . BP changes were consistently greater in hypertensives than in nonhypertensives , although interaction tests were nonsignificant . The Est intervention caused statistically significant BP reductions in individuals over and under age 50 . The Est Plus DASH intervention lowered BP in both age groups , and significantly more so in older individuals . In conclusion , diverse groups of people can adopt multiple lifestyle changes that can lead to improved BP control and reduced CVD risk Abstract . Blood pressure ( BP ) levels were recorded in 2 223 male and 2 205 female children and adolescents ranging in age from 7 to 18 years . In addition , 521 male adults ( soldiers ) ranging in age from 21 to 25 years were included in the study . Children and adolescents who participated in the survey were selected at r and om from the Elementary and High Schools . The results of the study showed that a gradual increase occurred in the systolic , as well as in the diastolic component of blood pressure from 7 to 18 years of age . By contrast , there was no increase with age in the systolic and diastolic blood pressure in the young male adult subjects , who had BP measurements comparable to those observed in children . A child was characterized as hypertensive according to the criteria outlined by Master et al. Children with BP between the 90th and the 95th percentile were considered as suspect hypertensive , whereas those with BP exceeding the 95th percentile were considered definitely hypertensive . The overall incidence of hypertension in children in this survey was 3.1 % The PREMIER trial assessed the aggregate effect on blood pressure ( BP ) of nationally recommended lifestyle modifications in free-living adults with high-normal ( stage 1 ) hypertension . Participants ( N=810 ) were r and omized to the advice-only group ; the established group ( consisting of weight loss , increased physical activity , and reduced sodium and alcohol intake ) ; or the established plus Dietary Approaches to Stop Hypertension ( DASH ) diet group ( consisting of the established interventions in addition to the DASH dietary pattern ) . The primary outcome was change in systolic BP at 6 months . Net of advice only , mean systolic BP declined by 3.7 mm Hg for members of the established group ( p<0.001 ) and 4.3 mm Hg for the established plus DASH group ( p<0.001 ) . The prevalence of hypertension decreased from a baseline of 38 % to 17 % in the established group ( p=0.01 ) and to 12 % in the established plus DASH group ( p<0.001 ) compared with a decrease to 26 % in the advice-only group . The PREMIER trial demonstrated that persons with above-optimal BP and stage 1 hypertension can make multiple lifestyle changes leading to better control of BP Epidemiologic studies , animal models , and preliminary clinical trials in children implicate uric acid in the development of essential hypertension . Controversy remains as to whether the observations indicate a general mechanism or a surrogate phenomenon . We sought to determine whether uric acid is a causative mediator of increased blood pressure ( BP ) and impaired vascular compliance . We report a r and omized , double-blinded , placebo-controlled trial comparing 2 mechanisms of urate reduction with placebo in prehypertensive , obese , adolescents , aged 11 to 17 years . Subjects were r and omized to the xanthine oxidase inhibitor , allopurinol , uricosuric , probenecid , or placebo . Subjects treated with urate-lowering therapy experienced a highly significant reduction in BP . In clinic systolic BP fell 10.2 mm Hg and diastolic BP fell 9.0 mm Hg in treated patients compared with a rise of 1.7 mm Hg and 1.6 mm Hg systolic and diastolic BP , respectively in patients on placebo . Urate-lowering therapy also result ed in significant reduction in systemic vascular resistance . These data indicate that , at least in adolescents with prehypertension , uric acid causes increased BP that can be mitigated by urate lowering therapy
The results suggest that despite the existence of hegemonic thinking to guide these relationships , BP and physical activity do not always have negative associations , and BP and obesity do not always have positive associations .
In the light of the importance of the impacts that obesity and physical activity may have on  blood pressure ( BP ) among adolescents , and the suggestion that abnormal pressure levels at young ages are maintained into more mature stages of these individuals ' lives , the scope of this study is to conduct a systematic review of the associations between obesity and BP and between physical activity and BP among adolescents .