Cardiorespiratory Fitness Associates with Blood Pressure and Metabolic Health of Children-The Arkansas Active Kids Study.

Introduction High blood pressure (HBP) in children causes pre-clinical damage to the heart and accelerates atherosclerosis. Current pharmacological treatments have limited ability to prevent end-organ damage, particularly that of the kidneys. A contrasting element between adult vs. pediatric HPB treatment, is the emphasis in adults on exercise regimens that target increments in cardiorespiratory fitness [CRF, (peak VO2)]. The aim of this study was to evaluate the association of CRF with blood pressure percentiles and blood pressure status in children with normal and excessive adiposity (NA vs. EA). An exploratory aim was to measure associations of CRF with a) other cardiovascular disease risk factors commonly found in children with HBP, and b) kidney function. Methods Children (n= 211), attended one study visit. CRF was measured using an incremental bike test, and body composition by dual-energy X-ray absorptiometry. Fat-free mass (FFM) index was calculated as kilograms of fat-free mass per square meter. Multiple logistic and linear regression analyses were used to model the probability of HBP, and other variables of interest [plasma lipids, HOMA2-IR, ALT, and glomerular filtration rate (eGRF)] against peak VO2. Results CRF interacted with adiposity status in predicting the probability of HBP. Each additional milliliter per minute per FFMI in peak VO2 decreased the odds of HBP by 8% in the EA group only (OR= 0.92; CI= 0.87-0.99). Systolic and diastolic blood pressure percentiles decreased, and eGFR increased with increasing CRF in both adiposity-level groups. HOMA2-IR and ALT decreased with increasing CRF in children with EA only. Conclusions Higher CRF associated with decreased probability of clinical HBP, lower insulin resistance, and improved liver function in children with EA. Yet, blood pressure percentiles and kidney function improved with increasing CRF irrespective of adiposity status.