Independent and combined effects of physical activity and sedentary behavior on blood pressure in adolescents: gender differences in two cross-sectional studies

PLoS One. 2013 May 1;8(5):e62006. doi: 10.1371/journal.pone.0062006. Print 2013.


Objectives: To examine the independent and combined association of physical activity (PA) and sedentary behavior (SB) on both systolic (SBP) and diastolic blood pressure (DBP) in adolescents from two observational studies.

Methods: Participants from two cross-sectional studies, one conducted in Europe (n = 3,308; HELENA study) and the other in Brazil (n = 991; BRACAH study), were selected by complex sampling. Systolic and diastolic blood pressure (outcomes), PA and SB, both independently and combined, and potential confounders were analyzed. Associations were examined by multilevel linear regression.

Results: Performing the recommended amount of PA (≥ 60 min/d) attenuated the effect of SB on DBP in BRACAH study girls and in boys from both studies. In contrast, PA did not attenuate the effects of SB on the SBP of girls in the HELENA study. The combination of less than recommended levels of PA with 2-4 h/d of sedentary behavior was found to be associated with increased SBP in boys from both studies.

Conclusions: Meeting current PA recommendations could mediate the association between SB and DBP in both sexes. In boys, the joint effect of low levels of PA and excessive sedentary activity increases SBP levels. Longitudinal studies are required to confirm these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Pressure*
  • Child
  • Cross-Sectional Studies
  • Exercise*
  • Female
  • Humans
  • Linear Models
  • Male
  • Sedentary Behavior*
  • Sex Distribution
  • Surveys and Questionnaires

Grant support

The HELENA Study received financial support from the European Community Sixth RTD Framework Programme (contract FOOD-CT-2005-007034). The writing group takes sole responsibility for the content of this article. This study was also supported by grants from the Spanish Ministry of Health: Maternal, Child Health and Development Network (number RD08/0072), the Spanish Ministry of Education (EX-2008- 0641) and the Swedish Heart-Lung Foundation (20090635). The BRACAH survey received no funding. ACFM received a scholarship from the São Paulo State Research Foundation (FAPESP: proc. 2011/11137-1 and 2011/20662-2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.