Cardiorespiratory fitness predicts hypertension risk in paediatric population

In children and adolescents, higher cardiorespiratory fitness (CRF) is independently predictive of reduced primary hypertension risk, suggests a study.

After adjustment, each 5-ml/kg/min increase in CRF correlated with a 30-percent decrease in the risk of hypertension (odds ratio [OR], 0.70, 95 percent confidence interval [CI], 0.63‒0.78; p<0.001).

Participants with CRF <44.7 ml/kg/min showed a 3.35-fold higher hypertension risk than those whose CRF was ≥44.7 ml/kg/min (OR, 3.35, 95 percent CI, 2.21‒5.16; p<0.001). Subgroup analyses confirmed consistency across age, sex, height, and BMI status (p>0.05 for interaction).

Notably, individuals with overweight or obesity had a 35-percent risk reduction per 5-ml/kg/min CRF improvement (OR, 0.65, 95 percent CI, 0.57‒0.74).

Additionally, CRF showed an inverse relationship with systolic (SBP), diastolic (DBP), and mean arterial blood pressure; resting and peak heart rate; peak SBP/DBP; and rate-pressure product (p<0.05 for all).

“Higher CRF is independently associated with reduced primary hypertension risk in children and adolescents, highlighting its role as a modifiable protective factor, particularly among overweight/obese youth,” the researchers said.

“These findings support CRF-enhancing interventions as a preventive strategy against paediatric hypertension,” they added.

In total, 972 participants aged 10‒17 years participated in this single-centre case‒control study. Of these, 352 were hypertensive and 602 normotensive (controls).

The researchers used a validated equation derived from treadmill tests to quantify CRF as peak oxygen uptake (VO2peak). They evaluated CRF-hypertension associations using logistic regression models, restricted cubic splines, and subgroup analyses, adjusted for age, sex, height, and overweight or obesity. Multivariate linear regression was used to assess the link between CRF and BP or heart rate parameters.