Physical activity and lifestyle interventions for children at cardiovascular risk

A systematic review

Authors

DOI:

https://doi.org/10.35469/ak.2025.503

Keywords:

physical activity, cardiovascular risk, hypertension, obesity, pediatric, lifestyle interventions

Abstract

Introduction: Structured physical activity and lifestyle changes are promising strategies to reduce cardiovascular risk in children and adolescents. We hypothesize that programs meeting the minimum thresholds of frequency and duration—particularly those combining aerobic and resistance components—can significantly lower the blood pressure in at-risk pediatric populations.

Purpose: To synthesize current evidence on the effectiveness of aerobic, resistance, and combined exercise interventions, alongside lifestyle modifications, in reducing cardiovascular risk among children and adolescents.

Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO CRD42025644256). Searches covered January 2015 to March 2025 across MEDLINE (PubMed), SPORTDiscus (EBSCO), and the Cochrane Library. The included studies were RCTs or quasi-experimental designs integrating exercise with dietary or behavioral components. The primary outcomes were blood pressure, lipid profile, body composition, physical fitness, and health-related quality of life. Study quality was assessed using the PEDro scale and Cochrane RoB 2.0 tool.

Results: Twenty-six studies (mean PEDro score: 9.9/10) met the inclusion criteria. Combined aerobic and resistance training with nutritional or behavioral support led to reductions in systolic/diastolic BP (–5 to –8 mmHg), body fat (–2 to –4%), and cholesterol (–10 to –15 mg/dL), alongside gains in aerobic capacity. Interventions involving families and school personnel showed greater adherence and cardiometabolic improvements.

Conclusions: Integrated physical activity and lifestyle programs are effective at reducing cardiovascular risk markers in pediatric populations. Early implementation in supportive environments is essential for long-term health benefits.

Downloads

Download data is not yet available.

References

Aguilar-Cordero, M. J., Rodríguez-Blanque, R., León-Ríos, X., Expósito Ruiz, M., García-García, I., & Sánchez-López, A. M. (2020). Influence of physical activity on blood pressure in children with overweight/obesity: A randomized clinical trial. American Journal of Hypertension, 33(2), 131–136. https://doi.org/10.1093/ajh/hpz174

Anderson, Y. C., Wynter, L. E., Grant, C. C., Cave, T. L., Derraik, J. G. B., Cutfield, W. S., & Hofman, P. L. (2017). A novel home-based intervention for child and adolescent obesity: The results of the Whānau Pakari randomized controlled trial. Obesity, 25(11), 1965–1973. https://doi.org/10.1002/oby.21967

André, N., & Béguier, S. (2015). Using motivational interviewing as a supplement to a physical activity program in obese adolescents: A RCT study. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity, 20(4), 519–523. https://doi.org/10.1007/s40519-015-0219-7

Arenaza, L., Medrano, M., Oses, M., Amasene, M., Díez, I., Rodríguez-Vigil, B., & Labayen, I. (2020). The effect of a family-based lifestyle education program on dietary habits, hepatic fat, and adiposity markers in 8–12-year-old children with overweight/obesity. Nutrients, 12(5), 1443. https://doi.org/10.3390/nu12051443

Benenson, I., Waldron, F. A., & Porter, S. (2020). Pediatric hypertension: A guideline update. The Nurse practitioner, 45(5), 16–23. https://doi.org/10.1097/01.NPR.0000660332.31690.68

Biernat, K., Kuciel, N., Mazurek, J., & Hap, K. (2024). Is it possible to train the endothelium?—A narrative literature review. Life, 14(5), 616. https://doi.org/10.3390/life14050616

Bodine, S. C., Stitt, T. N., Gonzalez, M., et al. (2001). Akt/mTOR pathway is a crucial regulator of skeletal muscle hypertrophy and can prevent muscle atrophy in vivo. Nature Cell Biology, 3(11), 1014–1019. https://doi.org/10.1038/ncb1101-1014

Briones-Arteaga, E. M. (2016). Ejercicios físicos en la prevención de hipertensión arterial [Physical exercises in the prevention of arterial hypertension]. Medisan, 20(1), 35–41.

Bruyndonckx, L., Hoymans, V. Y., De Guchtenaere, A., Van Helvoirt, M., Van Craenenbroeck, E. M., Frederix, G., Lemmens, K., Vissers, D. K., Vrints, C. J., Ramet, J., & Conraads, V. M. (2015). Diet, exercise, and endothelial function in obese adolescents. Pediatrics, 135(3), e653–e661. https://doi.org/10.1542/peds.2014-1577

Budts, W., Pieles, G. E., Roos-Hesselink, J. W., Sanz de la Garza, M., D'Ascenzi, F., Giannakoulas, … Papadakis, M. (2020). Recommendations for participation in competitive sport in adolescent and adult athletes with Congenital Heart Disease (CHD): position statement of the Sports Cardiology & Exercise Section of the European Association of Preventive Cardiology (EAPC), the European Society of Cardiology (ESC) Working Group on Adult Congenital Heart Disease and the Sports Cardiology, Physical Activity and Prevention Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC). European Heart Journal, 41(43), 4191–4199. https://doi.org/10.1093/eurheartj/ehaa501

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G.,… Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451–1462. https://doi.org/10.1136/bjsports-2020-102955

Clevenger, K. A., McNarry, M. A., Mackintosh, K. A., & Berrigan, D. (2022). Association of recess provision with elementary school-aged children's physical activity, adiposity, and cardiorespiratory and muscular fitness. Pediatric exercise science, 35(2), 99–106. https://doi.org/10.1123/pes.2021-0190

Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.

Consitt, L. A., Dudley, C., & Saxena, G. (2019). Impact of endurance and resistance training on skeletal muscle glucose metabolism in older adults. Nutrients, 11(11), 2636. https://doi.org/10.3390/nu11112636

De la Cerda Ojeda, F., & Herrero Hernando, C. (2014). Hipertensión arterial en niños y adolescentes [Arterial hypertension in children and adolescents]. Protocolos diagnósticos y terapéuticos en Pediatría, 1, 171–189.

del Valle Soto, M., Manonelles Marqueta, P., de Teresa Galván, C., Franco Bonafonte, L., Luengo Fernández, E., & Gaztañaga Aurrekoetxea, T. (2015). Prescripción de ejercicio físico en la prevención y tratamiento de la hipertensión arterial: Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) [Prescription of physical exercise in the prevention and treatment of arterial hypertension: Consensus document of the Sociedad Española de Medicina del Deporte (SEMED-FEMEDE)]. Archivos de Medicina del Deporte, 32(5), 281–312.

Durán Parrondo, C., & Rueda Núñez, F. (2020). Sociedad Gallega de Medicina del Deporte. (s.f.). Recomendaciones para la práctica del ejercicio físico: En el marco del estilo de vida saludable [Recommendations for the practice of physical exercise: Within the framework of a healthy lifestyle]. Fundación Galicia Saludable.

Eggertsen, C. N., Larsen, R. G., Duch, K., Simonsen, M. B., Christensen, C. B., Warner, T. C., … Hagstrøm, S. (2025). Feasibility and efficacy of adding high-intensity interval training to a multidisciplinary lifestyle intervention in children with obesity—a randomized controlled trial. International Journal of Obesity, 49(2), 269–277. https://doi.org/10.1038/s41366-024-01645-w

Epstein, L. H., Wilfley, D. E., Kilanowski, C., Quinntrin, T., Cook, S. R., Eneli, I. U., Geller, N., Lew, D., Wallendorf, M., Dore, P., Paluch, R. A., & Schechtman, K. B. (2023). Family-based behavioral treatment for childhood obesity implemented in pediatric primary care: A randomized clinical trial. JAMA, 329(22), 1947–1956. https://doi.org/10.1001/jama.2023.8061

Falkner, B., Gidding, S. S., Baker-Smith, C. M., Brady, T. M., Flynn, J. T., Malle, … Urbina, E. M.; American Heart Association Council on Hypertension; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Kidney in Cardiovascular Disease; Council on Lifestyle and Cardiometabolic Health; and Council on Cardiovascular and Stroke Nursing (2023). Pediatric primary hypertension: An underrecognized condition. A scientific statement from the American Heart Association. Hypertension, 80(6), e101–e111. https://doi.org/10.1161/HYP.0000000000000228

Ferrer Arrocha, M., Fernández Rodríguez, C., & González Pedroso, M. T. (2020). Factores de riesgo relacionados con el sobrepeso y la obesidad en niños de edad escolar. Revista Cubana de Pediatría, 92(2), e660. https://www.researchgate.net/publication/324788928_Lactancia_materna_obesidad_y_sindrome_metabolico_en_la_edad_escolar

Gamero, M. A., Idarreta, M. A., & Vargas, E. L. (2022). Cribado, diagnóstico y tratamiento de la hipertensión arterial en niños y adolescentes [Screening, diagnosis, and treatment of arterial hypertension in children and adolescents]. FMC—Formación Médica Continuada en Atención Primaria, 29(10), 536–544. https://doi.org/10.1016/j.fmc.2022.02.009

González Sánchez, R., Llapur Milián, R., Díaz Cuesta, M., Illa Cos, M. D. R., Yee López, E., & Pérez Bello, D. (2015). Estilos de vida, hipertensión arterial y obesidad en adolescentes [Lifestyle, arterial hypertension, and obesity in adolescents]. Revista Cubana de Pediatría, 87(3), 273–284.

González-Soto, C. E., Cárdenas-Rodríguez, M. L., & García-Morán, G. A. (2016). Percepción de los padres sobre el peso de niños con sobrepeso y obesidad [Parents’ perception of overweight and obesity in children]. EPH—International Journal of Medical and Health Sciences, 2(3), 21–23. https://doi.org/10.53555/eijmhs.v2i3.117

Hajj-Boutros, G., Karelis, A. D., Cefis, M., Morais, J. A., Casgrain, J., Gouspillou, G., & Sonjak, V. (2023). Potential mechanisms involved in regulating muscle protein turnover after acute exercise: A brief review. Frontiers in Physiology, 13, Article 1106425. https://doi.org/10.3389/fphys.2022.1106425

Higgins, J. P. G., & Green, S. (2019). Cochrane handbook for systematic reviews of interventions (Version 5.1.0). The Cochrane Collaboration.

Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., … Sterne, J. A. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343, d5928. https://doi.org/10.1136/bmj.d5928

Hossain, M. J., Levinson, A., George, D., Canas, J., Kumar, S., & Balagopal, P. B. (2018). Vitamin D status and cardiovascular risk in obesity: Effect of physical activity in nonvitamin D-supplemented adolescents. Metabolic Syndrome and Related Disorders, 16(4), 197–203. https://doi.org/10.1089/met.2017.0171

Howie, E. K., McVeigh, J. A., Abbott, R. A., Olds, T. S., & Straker, L. M. (2015). Multiple components of fitness improved among overweight and obese adolescents following a community-based lifestyle intervention. Journal of Sports Sciences, 34(16), 1581–1587. https://doi.org/10.1080/02640414.2015.1123285

Jerome, G. J., Fink, T., Brady, T., Young, D. R., Dickerson, F. B., Goldsholl, S., … Wang, N. Y. (2022). Physical activity levels and screen time among youth with overweight/obesity using mental health services. International Journal of Environmental Research and Public Health, 19(4), 2261. https://doi.org/10.3390/ijerph19042261

Kalantari, N., Mohammadi, N. K., Rafieifar, S., Eini-Zinab, H., Aminifard, A., Malmir, H., … Doaei, S. (2017). Indicator for success of obesity reduction programs in adolescents: Body composition or body mass index? Evaluating a school-based health promotion project after 12 weeks of intervention. International Journal of Preventive Medicine, 8, 73. https://doi.org/10.4103/ijpvm.IJPVM_306_16

Kleppang, A. L., Abildsnes, E., Haraldstad, K., & Stea, T. H. (2024). Changes in health-related quality of life and sleep habits after a 6-month non-randomised cluster-controlled trial among children with overweight or obesity. European Child & Adolescent Psychiatry, 33(9), 3179–3187. https://doi.org/10.1007/s00787-024-02375-0

Kokkvoll, A., Grimsgaard, S., Steinsbekk, S., Flægstad, T., & Njølstad, I. (2015). Health in overweight children: 2-year follow-up of Finnmark Activity School—a randomised trial. Archives of Disease in Childhood, 100(5), 441–448. https://doi.org/10.1136/archdischild-2014-307107

Llapur Milián, R., & González Sánchez, R. (2017). La enfermedad cardiovascular aterosclerótica desde la niñez a la adultez [Atherosclerotic cardiovascular disease from childhood to adulthood]. Revista Cubana de Pediatría, 89(3).

López-Iracheta, R., Martín-Calvo, N., Moreno-Galarraga, L., & Moreno-Villares, J. M. (2024). Efectos del confinamiento por COVID-19 en la calidad del sueño, la actividad física, el tiempo de pantallas y la alimentación en los niños [Effects of COVID-19 lockdown on sleep quality, physical activity, screen time, and diet in children]. Nutrición Hospitalaria, 41(4), 781–787.

Lurbe, E., Cifkova, R., Cruickshank, J. K., Dillon, M. J., Ferreira, I., Invitti, C., … Zanchetti, A. (2010). Manejo de la hipertensión arterial en niños y adolescentes: recomendaciones de la Sociedad Europea de Hipertensión [Management of arterial hypertension in children and adolescents: Recommendations of the European Society of Hypertension]. Anales de Pediatría, 73(1), 51–e1. https://doi.org/10.1016/j.anpedi.2010.04.001

Lurbe, E., Fernandez-Aranda, F., & Wühl, E. (2021). Red europea para la investigación de la presión arterial en niños y adolescentes (COST Action CA19115) [European network for blood pressure research in children and adolescents]. Anales de Pediatría, 94(6), 421–e1. https://doi.org/10.1016/j.anpedi.2021.01.015

Hernández-Magdariaga, A., Hierrezuelo-Rojas, N. R., Velásquez-Ferreira, L. M., Ávila-Velásquez, M., & Videaux-Caballero S. D. R. (2023). Factores de riesgo cardiometabólicos en adolescentes [Cardiometabolic risk factors in adolescents]. Revista Cubana de Cardiología y Cirugía Cardiovascular, 29(1), 1354.

Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83(8), 713–721. https://doi.org/10.1093/ptj/83.8.713

Malarvizhi, D., & Pasupathy, S. (2023). Long term lifestyle modifications on submaximal exercise tolerance test in overweight children, Tamil Nadu, India. International Journal of Nutrition, Pharmacology, Neurological Diseases, 13(1), 32–39. https://doi.org/10.4103/ijnpnd.ijnpnd_75_22

Mameli, C., Brunetti, D., Colombo, V., Bedogni, G., Schneider, L., Penagini, F., … Zuccotti, G. V. (2018). Combined use of a wristband and a smartphone to reduce body weight in obese children: Randomized controlled trial. Pediatric Obesity, 13(2), 81–87. https://doi.org/10.1111/ijpo.12201

Martí, A., Martínez, I., Ojeda-Rodríguez, A., & Azcona-Sanjulian, M. C. (2021). Higher lipopolysaccharide binding protein and chemerin concentrations were associated with metabolic syndrome features in pediatric subjects with abdominal obesity during a lifestyle intervention. Nutrients, 13(2), 289. https://doi.org/10.3390/nu13020289.

Morales-Alamo, D., & Calbet, J. A. L. (2016). AMPK signaling in skeletal muscle during exercise: Role of reactive oxygen and nitrogen species. Free radical biology & medicine, 98, 68–77. https://doi.org/10.1016/j.freeradbiomed.2016.01.012

Morell-Azanza, L., Ojeda-Rodríguez, A., Ochotorena-Elicegui, A., Martín-Calvo, N., Chueca, M., Marti, A., & Azcona-San Julian, C. (2019). Changes in objectively measured physical activity after a multidisciplinary lifestyle intervention in children with abdominal obesity: A randomized controlled trial. BMC Pediatrics, 19(1), 90. https://doi.org/10.1186/s12887-019-1468-9

Moxley, E., Habtzghi, D., Klinkhamer, N., Wang, H., Donnelly, S., & Dykhuizen, J. (2019). Prevention and treatment of pediatric obesity: A strategy involving children, adolescents, and the family for improved body composition. Journal of Pediatric Nursing, 45, 13–19. https://doi.org/10.1016/j.pedn.2018.12.010

Nayak, B. S., & Bhat, V. H. (2016). School-based multicomponent intervention for obese children in Udupi district, South India: A randomized controlled trial. Journal of Clinical and Diagnostic Research, 10(12), SC24–SC28. https://doi.org/10.7860/JCDR/2016/23766.9116

Ojeda-Rodríguez, A., Morell-Azanza, L., Martín-Calvo, N., Zalba, G., Chueca, M., Azcona-Sanjulian, M. C., & Marti, A. (2021). Association between favourable changes in objectively measured physical activity and telomere length after a lifestyle intervention in pediatric patients with abdominal obesity. Applied Physiology, Nutrition, and Metabolism, 46(3), 205–212. https://doi.org/10.1139/apnm-2020-0297

Oreskovic, N. M., Winickoff, J. P., Perrin, J. M., Robinson, A. I., & Goodman, E. (2016). A multimodal counseling-based adolescent physical activity intervention. Journal of Adolescent Health, 59(3), 332–337. https://doi.org/10.1016/j.jadohealth.2016.03.012

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., … Moher, D. (2021). Updating guidance for reporting systematic reviews: Development of the PRISMA 2020 statement. Journal of Clinical Epidemiology, 134, 103–112. https://doi.org/10.1016/j.jclinepi.2021.02.003

Pamplona-Cunha, H., Rosini, N., Caetano, R., Machado, M. J., & Silva, E. L. (2022). Lifestyle intervention in reducing cardiometabolic risk factors in students with dyslipidemia and abdominal obesity: A randomized study. International Journal of Cardiovascular Sciences, 35(1), 68–79. https://doi.org/10.36660/ijcs.20200286

Pedersen, B. K., & Febbraio, M. A. (2012). Muscles, exercise and obesity: Skeletal muscle as a secretory organ. Nature Reviews Endocrinology, 8(8), 457–465. https://doi.org/10.1038/nrendo.2012.49

Pérez-Caballero, M. D., León-Álvarez, J. L., Dueñas-Herrera, A., Alfonzo-Guerra, J. P., Navarro-Despaigne, D. A., de la Noval-García, R., … Morales-Salinas, A. (2017). Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial [Cuban guide for diagnosis, evaluation, and treatment of arterial hypertension]. Revista Cubana de Medicina, 56(4), 242–321.

Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020–2028. https://doi.org/10.1001/jama.2018.14854

Rodríguez-Torres, A. F., Rodríguez-Alvear, J. C., Guerrero-Gallardo, H. I., Arias-Moreno, E. R., Paredes-Alvear, A. E., & Chávez-Vaca, A. (2020). Beneficios de la actividad física para niños y adolescentes en el contexto escolar [Benefits of physical activity for children and adolescents in the school context]. Revista Cubana de Medicina General Integral, 36, e1535.

Rosas-Peralta, M., Medina-Concebida, L. E., Borrayo-Sánchez, G., Madrid-Miller, A., Ramírez-Arias, E., & Pérez-Rodríguez, G. (2016). Hipertensión arterial sistémica en el niño y adolescente [Systemic arterial hypertension in the child and adolescent]. Revista Médica del IMSS, 54(Suppl.), 52–66.

Son, W. M., Pekas, E. J., & Park, S. Y. (2020). Twelve weeks of resistance band exercise training improves age-associated hormonal decline, blood pressure, and body composition in postmenopausal women with stage 1 hypertension: a randomized clinical trial. Menopause, 27(2), 199–207. https://doi.org/10.1097/GME.0000000000001444

Stephens, M. M., Fox, B. A., & Maxwell, L. (2012). Therapeutic options for the treatment of hypertension in children and adolescents. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 6, CCRPM-S7602. https://doi.org/10.4137/CCRPM.S7602

Tjønna, A. E., Stølen, T. O., Bye, A., Volden, M., Slørdahl, S. A., Odegård, R., Skogvoll, E., & Wisløff, U. (2009). Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents. Clinical science, 116(4), 317–326. https://doi.org/10.1042/CS20080249

Tozo, J. V. A., Tadiotto, M. C., Tozo, T. A. A., de Menezes-Junior, F. J., Mota, J., de Pereira, B. O., … Leite, N. (2025). Effects of different physical exercise programs on blood pressure in overweight children and adolescents: systematic review and meta-analysis. BMC pediatrics, 25(1), 252. https://doi.org/10.1186/s12887-025-05575-y

Venegas-Rodríguez, E. D. L. C., Vitón-Castillo, A. A., Linares-Cánovas, L. P., Díaz-Pita, G. F. & Álvarez-Alvarez, M. D. L. C. (2021). Factores asociados a hipertensión arterial en una población pediátrica [Factors associated with arterial hypertension in a pediatric population]. CorSalud, 13(4), 445–452.

Wang, J. J., Lau, W. C., Wang, H. J., & Ma, J. (2015). Evaluation of a comprehensive intervention with a behavioural modification strategy for childhood obesity prevention: A nonrandomized cluster-controlled trial. BMC Public Health, 15, 1206. https://doi.org/10.1186/s12889-015-2535-2

Wang, X., Liu, J., Gao, D., Li, Y., Ma, Q., Chen, L., … Song, Y. (2022). Effectiveness of national multicentric school-based healthy lifestyles intervention among Chinese children and adolescents on knowledge, belief, and practice toward obesity at individual, family, and schools’ levels. Frontiers in Pediatrics, 10, 917376. https://doi.org/10.3389/fped.2022.917376

Weaver Jr, D. J. (2019). Pediatric hypertension: Review of updated guidelines. Pediatrics in Review, 40(7), 354–358. https://doi.org/10.1542/pir.2018-0014

Wesnigk, J., Bruyndonckx, L., Hoymans, V. Y., De Guchtenaere, A., Fischer, T., Schuler, G., Vrints, C. J., & Adams, V. (2016). Impact of lifestyle intervention on HDL-induced eNOS activation and cholesterol efflux capacity in obese adolescents. Cardiology Research and Practice, 2016, 2820432. https://doi.org/10.1155/2016/2820432

Whooten, R., Kerem, L., & Stanley, T. (2019). Physical activity in adolescents and children and relationship to metabolic health. Current opinion in endocrinology, diabetes, and obesity, 26(1), 25–31. https://doi.org/10.1097/MED.0000000000000455

Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., & Burnier, M. (2019). 2018 ESC/ESH guidelines for the management of arterial hypertension. Revista Española de Cardiología, 72(2), 160–185. https://doi.org/10.1016/j.recesp.2018.12.005

Wong, A., Sanchez-Gonzalez, M. A., Son, W. M., Kwak, Y. S., & Park, S. Y. (2018). The effects of a 12-week combined exercise training program on arterial stiffness, vasoactive substances, inflammatory markers, metabolic profile, and body composition in obese adolescent girls. Pediatric Exercise Science, 30(4), 480–486. https://doi.org/10.1123/pes.2017-0198

Writing Group Members; Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., & Wylie-Rosett, J. (2010). Heart disease and stroke statistics—2010 update: A report from the American Heart Association. Circulation, 121(7), e46–e215. https://doi.org/10.1161/CIRCULATIONAHA.109.192667

Xi, B., Zhang, T., Li, S., Harville, E., Bazzano, L., He, J., & Chen, W. (2017). Can pediatric hypertension criteria be simplified? A prediction analysis of subclinical cardiovascular outcomes from the Bogalusa Heart Study. Hypertension, 69(4), 691–696. https://doi.org/10.1161/HYPERTENSIONAHA.116.08782

Xu, H., Li, Y., Shang, X., Du, S., Zhang, Q., Liu, A., & Ma, G. (2020). Effect of comprehensive interventions including nutrition education and physical activity on high blood pressure among children: Evidence from a school-based cluster randomized controlled trial in China. International Journal of Environmental Research and Public Health, 17(23), 8944. https://doi.org/10.3390/ijerph17238944

Zhou, J., Sun, W., Tang, S., Jiang, D., Tan, B., Li, S., … Song, P. (2025). Effects of exercise interventions on blood pressure in children and adolescents with overweight or obesity: A systematic review and meta-analysis of randomized controlled trials. Journal of Adolescent Health, 76(3), 361–369. https://doi.org/10.1016/j.jadohealth.2024.09.017

Downloads

Published

05-09-2025

How to Cite

Contreras-Zapata, K. E., Martín Pérez, S. E., Cruz-Hidalgo, N. X., Rubio Zarapuz, A., Clemente Suárez, V. J., & Martín Pérez, I. M. (2025). Physical activity and lifestyle interventions for children at cardiovascular risk: A systematic review. Annales Kinesiologiae, 16(1), 61–94. https://doi.org/10.35469/ak.2025.503