Mark Amy E, Janssen Ian
School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Med Sci Sports Exerc. 2008 Jun;40(6):1007-12. doi: 10.1249/MSS.0b013e318169032d.
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.
儿童和青少年的身体活动(PA)与心血管健康之间的剂量反应关系尚不清楚。血压(BP)是衡量青少年心血管健康的一项实用且有效的指标。
本研究旨在探讨客观测量的PA与儿童和青少年BP之间的剂量反应关系。
样本包括来自2003/04年美国国家健康与营养检查调查的1170名8 - 17岁的青少年。使用Actigraph加速度计(美国佛罗里达州沃尔顿堡滩)测量PA,持续7天。每分钟2000次和3000次计数的阈值分别用于表示参与者进行总PA和中等至剧烈强度PA的分钟数。使用标准程序测量BP。收缩压和舒张压值根据年龄、身高和性别进行了调整。调整后的BP值>或 = 第90百分位数的参与者被认为患有高血压。使用36个分数多项式回归模型来获得最能拟合PA与收缩压、舒张压和高血压之间关系的剂量反应曲线。
在总PA以及中等至剧烈强度PA与收缩压和舒张压之间观察到反向剂量反应关系。曲线斜率适中,表明PA对平均BP值的影响最小。随着PA分钟数的增加,患高血压的可能性呈曲线下降。与不进行PA相比,在每天进行30分钟和60分钟中等至剧烈强度PA时,高血压的比值比(95%置信区间)分别为0.50(0.28 - 0.64)和0.38(0.17 - 0.52)。
在PA与平均收缩压和舒张压值之间观察到适度的剂量反应关系。然而,在预测高血压值时,PA对BP有很强的梯度效应。这些结果支持了公共卫生建议,即儿童和青少年每天应累计至少60分钟的中等至剧烈强度PA。