Effects of different physical exercise programs on blood pressure in overweight children and adolescents: systematic review and meta-analysis.

Abstract

Aims: The purpose of this meta-analysis was to systematically review studies in the literature that evaluated the effect of different exercise programs on blood pressure in overweight children and adolescents.

Data sources: In September 2024, studies were searched in six electronic databases (PubMed, Web of Science, Scopus, Sportdiscus, Lilacs, and Scielo) and in reference lists.

Study eligibility criteria, participants, and interventions: Randomized and non-randomized controlled trials with interventions involving physical exercise programs and assessment of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children and adolescents with overweight and/or obesity were considered for synthesis.

Study appraisal and synthesis methods: The quality of studies was assessed using the PEDro scale for studies with randomized clinical trials. Meta-analysis was conducted using a random model in the Review Manager Software.

Results: Seventeen studies were selected that involved 1,125 children and adolescents. The risk of bias score was considered moderate (five to eight points out of 11). The high-intensity interval training (HIIT) showed the largest effect, indicating a greater impact on BP reduction, while moderate-intensity continuous training (MICT) also had a significant effect, although with greater heterogeneity. No significant effects were found for the other types of exercise. For SBP, a summary effect of -0.44 (95% CI=-0.68; -0.20; I² = 73%) was observed. For DBP, the metanalysis indicated - 0.52 (95% CI=-0.73; -0.31; I² = 63%).

Limitations: There was a publication time limitation of ten years, and the search was restricted to articles published in journals indexed in databases, and there was also significant heterogeneity for the intervention subgroups, which can be explained by the moderate methodological quality of the studies.

Conclusions and implications of key findings: Considering the significant effects of exercise interventions on blood pressure, we suggest the development of more interventions based on physical exercise practice for overweight and obese children and adolescents, which may also add environmental elements, lasting at least 12 weeks, with three 60-minute sessions per week, better control of exercise intensity, as HIIT and MICT were more effective in promoting a reduction in blood pressure when compared to other types of exercise. The implementation of these programs must be carried out in a multicomponent and multiprofessional approach to guarantee the adherence of participants and promote significant and sustainable changes in the cardiovascular health of children and adolescents.

Systematic review registration number: PROSPERO no CRD42023469222.