Dose-Response Relation between Physical Activity and Blood Pressure in Youth

School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 3.98). 07/2008; 40(6):1007-12. DOI: 10.1249/MSS.0b013e318169032d
Source: PubMed


The dose-response relationship between physical activity (PA) and cardiovascular health in children and adolescents is unclear. Blood pressure (BP) is a practical and useful measure of cardiovascular health in youth.
This study aims to examine the dose-response relationship between objectively measured PA and BP in children and adolescents.
The sample included 1170 youth aged 8-17 yr from the 2003/04 U.S. National Health and Nutrition Examination Survey. PA was measured using Actigraph accelerometers (Ft. Walton Beach, FL, USA) over 7 d. Thresholds of 2000 and 3000 counts per minute were used to denote those minutes where the participants were engaged in total PA and moderate-to-vigorous intensity PA, respectively. BP was measured using standard procedures. Systolic and diastolic BP values were adjusted for age, height, and sex. Participants with adjusted BP values > or = 90th percentile were considered to have hypertension. Thirty-six fractional polynomial regression models were used to obtain the dose-response curve that best fit the relation between PA with systolic BP, diastolic BP, and hypertension.
Inverse dose-response relations were observed between total and moderate-to-vigorous PA with systolic and diastolic BP. The slopes of the curves were modest indicating a minimal influence of PA on mean BP values. The likelihood of having hypertension decreased in a curvilinear manner with increasing minutes of PA. At 30 and 60 min.d of moderate-to-vigorous PA, the odd ratios (95% confidence intervals) for hypertension were 0.50 (0.28-0.64) and 0.38 (0.17-0.52), respectively, in comparison to no PA.
A modest dose-response relation was observed between PA and mean systolic and diastolic BP values. PA did, however, have a strong gradient effect on BP when predicting hypertensive values. These results support the public health recommendation that children and youth accumulate at least 60 min of moderate-to-vigorous PA daily.

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    • "Stressors such as exercise strength, pain, and occupational noise can cause dose-related response effects in the cardiovascular system, most frequently detectable through BP as a stress marker (Mark and Janssen 2008; Talbott et al. 1999; Umeda et al. 2010). However, the dose-related effects of job responsibility have not been clearly identified . "
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    ABSTRACT: Night duty has been recognized as a significantly harmful stressor for physicians. However, the relationship between various levels of duty loading and stress response is unknown. This study examined whether duty load increases cardiovascular stress indicators in a dose-dependent manner. An unallocated prospective observational study was conducted among physicians performing various levels of duties in a secondary referral medical center between 2011 and 2012. Heart rate variability (HRV), blood pressure (BP), and other stress markers of 12 attending physicians were compared during different duty loads: non-duty day (NDD), duty day with one duty area and three wards (1DD), and duty day with two duty areas and six wards (2DD). During the regular sleep time (i.e., 11 p.m. to 5 a.m.), the relative sympathetic modulations measured using the HRV were 59.0 ± 9.3, 61.6 ± 10.4, and 64.4 ± 8.9 for NDD, 1DD, and 2DD, respectively (p = 0.0012); those for relative parasympathetic modulations were 37.4 ± 9.4, 34.8 ± 9.8, and 32.0 ± 8.8 for NDD, 1DD, and 2DD, respectively (p = 0.0015). The percentages of abnormal systolic BPs were 9.7 ± 13.2 %, 25.3 ± 21.8 %, and 31.5 ± 21.0 % for NDD, 1DD, and 2DD, respectively (p = 0.003), and the percentages of abnormal diastolic BP were 6.7 ± 11.0 %, 18.3 ± 11.1 %, and 27.1 ± 30.9 % for NDD, 1DD, and 2DD, respectively (p = 0.002). Total sleep time was negatively associated with sympathetic/parasympathetic balance and the percentage of abnormal diastolic BP. Admitting new patients was positively associated with the percentages of abnormal systolic BP. This observational analysis suggests that the dose-dependent stress responses of the cardiovascular system in physicians were caused by the duty load.
    International Archives of Occupational and Environmental Health 08/2015; DOI:10.1007/s00420-015-1080-8 · 2.20 Impact Factor
    • "Stressors such as exercise strength, pain, and occupational noise can cause dose-related response effects in the cardiovascular system, most frequently detectable through BP as a stress marker (Mark and Janssen 2008; Talbott et al. 1999; Umeda et al. 2010). However, the dose-related effects of job responsibility have not been clearly identified . "
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    ABSTRACT: Developmental status at birth and subsequent obesity have been implicated in the development of childhood atopic dermatitis (AD) and allergic rhinitis (AR). The current study analysed the cohort data of 74 688 junior high school students from a national retrospective birth cohort study in Taiwan. A random 10% sample was selected from singleton livebirths with complete data on the analytical variables of interest. Atopic disorders, including AD and AR, were assessed by questionnaires (International Study of Asthma and Allergies in Childhood). Logistic regression analyses were applied with adjustments for related risk factors. Among subjects mainly 13-15 years of age, the estimated prevalence was 7.6% for AD and 22.4% for AR. While the role of fetal growth in allergic disorders was less evident, the risk of developing AD and AR were both influenced by a combination of fetal growth status and adolescent body mass index (BMI). Compared with those with normal fetal growth and school-aged BMI, the risk of developing AD increased 64% among adolescents with both restricted fetal growth and high BMI (odds ratio 1.64, 95% confidence interval 1.37, 1.97). The risk for this combination was higher than that for either restricted fetal growth or high BMI alone. Nevertheless, the overall interaction between BMI and fetal growth status on atopic disorders did not reach statistical significance. Excessive weight gain could be an important risk factor related to developing atopic dermatitis and allergic rhinitis during adolescence, especially among infants born small for gestational age. © 2015 John Wiley & Sons Ltd.
    Paediatric and Perinatal Epidemiology 07/2015; 29(5). DOI:10.1111/ppe.12215 · 3.13 Impact Factor
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    • "To our knowledge, no previous pediatric studies have investigated the independent health influence of the weekly fractionalization of MVPA. Previous population-based studies of children and youth from the United States and Europe have documented a relationship between average daily MVPA, as measured by accelerometer, with individual cardiometabolic risk factors [29,40] and summary cardiometabolic risk factors scores [31,41]. Our findings that physically active Canadian children and youth tend to have a more favorable overall cardiometabolic risk factor profiles than their insufficiently active counterparts is consistent with these prior observations. "
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    ABSTRACT: Background The influence of the fractionalization of moderate- to vigorous- intensity physical activity (MVPA) throughout the week on the health of children is unknown. We compared cardiometabolic risk factors in physically active children who accumulated their weekly MVPA in different patterns. Methods We studied 745 participants aged 6–19 years. MVPA was measured using accelerometers over 7 days. Three groups were created: Insufficiently Active, <60 minutes/day of MVPA on average; Infrequently Active, ≥60 minutes/day of MVPA on average but exceeding the 60 minute target <5 days; and Frequently Active, ≥60 minutes/day MVPA on average and exceeding the 60 minute target ≥5 days. Percentile scores for 8 cardiometabolic risk factors were determined. Results The least favorable cardiometabolic risk factor profile was observed in the Insufficiently Active group. The Frequently Active group had more favorable (5–6 percentile unit difference) diastolic blood pressure, HDL-cholesterol, insulin resistance, and metabolic syndrome scores than the Infrequently Active group, although only the difference for insulin resistance was statistically significant (P < 0.05). These differences remained after controlling for the weekly volume of MVPA. Conclusion The fractionalization of MVPA throughout the week was associated with insulin resistance.
    BMC Public Health 06/2013; 13(1):554. DOI:10.1186/1471-2458-13-554 · 2.26 Impact Factor
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