Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, CA, USA.
Division of Nephrology, Department of Medicine, University of California, San Francisco, CA, USA.
Pediatr Nephrol. 2024 Aug;39(8):2467-2474. doi: 10.1007/s00467-024-06340-6. Epub 2024 Mar 19.
Promoting physical activity among young individuals with cardiovascular disease (CVD) risk factors such as hypertension, diabetes, or chronic kidney disease can lower systolic blood pressure (BP). We sought to determine whether a 6-month intervention using a physical activity tracker was feasible and effective, compared with usual care.
Participants were recruited at a single academic medical center. Those aged 8-30 years were randomized in a 2:1 ratio to either the intervention (use of a Fitbit physical activity tracker coupled with feedback regarding the participant's step count) or usual care. The primary feasibility outcomes were screening-to-enrollment ratio and 6-month retention rates; the primary clinical outcome was a change in systolic BP from 0-6 months.
Sixty-three participants were enrolled (57% male; mean age: 18 ± 4 years). The screening-to-enrollment ratio was 1.8:1. Six-month retention was 62% in the intervention group and 86% in the control group (p = 0.08). Mean change in systolic BP in the intervention group was not significantly different from the control group at 6 months (- 2.3 mmHg; 95% CI - 6.5, 1.8 vs. 3.0 mmHg; 95% CI - 2.5, 8.4, respectively, p = 0.12).
Among children and young adults at elevated CVD risk, the use of a physical activity tracker coupled with tailored feedback regarding their step count progress was feasible but not sustained over time. Physical activity tracker use did not have a statistically significant effect on BP after 6 months. Augmented strategies to mitigate risk in young patients at high risk for early-onset CVD should be explored. This trial is registered at ClinicalTrials.gov (NCT03325426).
在患有高血压、糖尿病或慢性肾脏病等心血管疾病 (CVD) 危险因素的年轻个体中,促进身体活动可以降低收缩压。我们旨在确定使用活动追踪器进行 6 个月的干预与常规护理相比是否可行且有效。
参与者在一家学术医疗中心招募。年龄在 8 至 30 岁之间的参与者按照 2:1 的比例随机分为干预组(使用 Fitbit 活动追踪器,并提供有关参与者步数的反馈)或常规护理组。主要可行性结局为筛查入组率和 6 个月保留率;主要临床结局为 0-6 个月期间收缩压的变化。
共纳入 63 名参与者(57%为男性;平均年龄:18 ± 4 岁)。筛查入组率为 1.8:1。干预组的 6 个月保留率为 62%,对照组为 86%(p = 0.08)。干预组的收缩压在 6 个月时的变化与对照组无显著差异(-2.3mmHg;95%CI-6.5, 1.8 与 3.0mmHg;95%CI-2.5, 8.4,分别,p = 0.12)。
在患有 CVD 风险升高的儿童和年轻人中,使用活动追踪器并结合其步数进展的个性化反馈是可行的,但随着时间的推移无法持续。在 6 个月后,使用活动追踪器对血压没有统计学上的显著影响。应该探索增强策略来减轻患有早期 CVD 风险高的年轻患者的风险。该试验在 ClinicalTrials.gov(NCT03325426)注册。