Association between aerobic fitness and high blood pressure in adolescents in Macedonia evidence for criterion-referenced cut-points

Abstract

There is a lack of criterion reference standards for assessing health fitness in children and adolescents. The research was intended to determine the link between fitness and high blood pressure (HBP) and determine the cut-points that best predict high blood pressure (HBP) among adolescents. This cross-sectional study included 1261 adolescents, which were defined as a population of healthy adolescents at the age of 11-14 years, from Macedonian ethnicity and urban origin. The aerobic fitness is evaluated with the three-minute step test. The systolic and diastolic blood pressure were measured with oscillometric method, whereby is used digital sphygmomanometer Omron. Analyses controlled for age, body fat, socioeconomic status and biological maturation. Receiver Operating Characteristic (ROC) curves demonstrated that three minute step test could discriminate high blood pressure in both sexes (male: AUC = 0.63; female: AUC = 0.64). The cut-points with the best discriminatory power for high blood pressure were 41 mL•kg-1•min-1 for males and 36 mL•kg-1•min-1 for females. Мales (OR = 1.7; 95% CI: 1.3-3.0) and famales (OR: 2.2; CI 95%: 1.2-4.1) with low aerobic fitness levels were more likely to have high blood pressure. Three minute step tests are inversely associated with blood pressure and cut-points from ROC analyses have good discriminatory power for high blood pressure