Evidence map›Paper›PMID 42401992›Full record

ArticleChinese medical journal2026

Secular trends in society-, school-, and individual-level factors related to physical activity and their associations with elevated blood pressure among 0.6 million children and adolescents.

Jieyu Liu, Xinli Song, Qi Ma, Jianuo Jiang, Yi Zhang, Ruolin Wang, Ziqi Dong, Li Chen, Yang Qin, Wen Yuan and 5 more

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Article in Chinese medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Jieyu LiuInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Xinli SongInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Qi MaInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Jianuo JiangInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Yi ZhangInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Ruolin WangInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Ziqi DongInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Li ChenInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Yang QinInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Wen YuanInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Tongjun GuoInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Zhiying SongInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Jun MaInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Yanhui DongSchool of Public Health, Peking University and National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
Yi SongInstitute of Child and Adolescent Health, Peking University, Beijing 100191, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPhysical activity (PA) is a key modifiable factor for elevated blood pressure (EBP). We aimed to clarify the evolving relationships between PA and EBP in childhood or adolescence by examining multilevel factors within an ecological model.

methodsNational data were extracted from 2010, 2014, and 2019 cycles of the Chinese National Survey on Students' Constitution and Health, using a multistage stratified cluster sampling design. We defined EBP by the updated Chinese reference standards and obesity by sex- and age-specific body mass index (BMI) cutoffs. Inadequate PA was defined as <1 h/day; ecological factors at society-, school-, and individual-level were collected through a questionnaire. Multilevel logistic regression, interaction analyses, and population-attributable fractions were used to evaluate associations between multilevel ecological factors related to PA and EBP.

resultsWe included 642,386 participants (7-18 years). The EBP prevalence increased from 13.6% to 17.9% alongside increasing obesity, while inadequate PA decreased in prevalence. Inadequate PA was associated with EBP in 2010, with the odds ratio (OR) of 1.17 (95% confidence interval [CI]: 1.04, 1.21) but attenuated during 2010-2019. The multilevel factors related to PA displayed interactions to reduce EBP risk (P for interaction <0.05). At the societal-level, urban residence was protective against EBP, whereas a lack of exercise facilities increases the odds. At the school-level, inadequate physical education and sports competitions, coupled with unhealthy dietary lifestyles at the individual-level, contributed to EBP (P <0.05). The contributions of individual-level ecological factors related to PA decreased but of societal- and school-level increased on EBP, independent of obesity.

conclusionsA rise in EBP burdens during 2010-2019 contrasted with an increase in PA. PA-related ecological factors across society-, school-, and individual-level exhibited complex interactions on EBP. Although the impact of individual-level lifestyles on EBP was waning and obesity remained a primary concern, there was increased recognition of societal- and school-level's ecological factors related to PA during 2010-2019. Promoting PA requires a comprehensive approach that addresses both facilitating and inhibiting factors, which is crucial for healthy blood pressure (BP).

Indexed as

ExerciseHypertensionAdolescentBlood PressureBody Mass IndexChildFemaleHumansMaleObesitySchoolsAdolescentBlood pressureChildhoodEcological factorsHypertensionIndividualPhysical activitySchoolSocietyYouth

Identifiers

PMID42401992
PMCPMC13331418

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.