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.
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
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 .