European Journal of Applied Physiology

, Volume 119, Issue 2, pp 577–585 | Cite as

The effects of a 12-week jump rope exercise program on abdominal adiposity, vasoactive substances, inflammation, and vascular function in adolescent girls with prehypertension

  • Ki-Dong Sung
  • Elizabeth J. Pekas
  • Steven D. Scott
  • Won-Mok Son
  • Song-Young ParkEmail author
Original Article



Childhood obesity is strongly associated with cardiovascular disease (CVD) development. It is necessary to combat unfavorable outcomes of obesity at a young age by utilizing effective interventions, such as exercise.


We sought to examine the effects of a jump rope exercise program on CVD risk factors, including body composition, vasoactive substances, inflammation, and vascular function in prehypertensive adolescent girls.


Forty girls (age 14–16) were recruited and randomly assigned to a jump rope exercise group (EX, n = 20) or control group (CON, n = 20). Body composition, nitrate and nitrite levels, endothelin-1 (ET-1), C-reactive protein (CRP), systolic blood pressure and diastolic blood pressure (SBP, DBP), and arterial stiffness were measured before and after 12 weeks.


There were significant group by time interactions following the 12-week program for body composition (from 33.8 ± 3.6 to 30.2 ± 3.1%), central adiposity (from 86.4 ± 4 to 83.3 ± 5 cm), SBP (from 126 ± 3.3 to 120 ± 2.1 mmHg), and brachial-to-ankle pulse wave velocity (from 8.2 ± 1.0 to 7.4 ± 0.2 m/s). Nitrate/nitrite levels increased (from 54.5 ± 5.1 to 57.2 ± 5.2 µmol) along a reduction in CRP levels (from 0.5 ± 0.4 to 0.2 ± 0.1 mg/L). There were no significant changes in ET-1 (P = 0.22).


These findings indicate that jump rope exercise may be an effective intervention to improve these CVD risk factors in prehypertensive adolescent girls. Jumping rope is an easily accessible exercise modality that may have important health implications for CVD prevention in younger populations.


Arterial stiffness Central adiposity C-reactive protein Endothelin-1 Nitric oxide Pulse wave velocity 



Analysis of variance


Brachial-to-ankle pulse wave velocity


Bioelectrical impedance analysis


Body mass index


Blood pressure


Beats per minute


Control group


C-reactive protein


Cardiovascular disease


Diastolic blood pressure




Exercise intervention group


Heart rate reserve


Nitric oxide


Rating of perceived exertion


Standard deviation of the mean


Systolic blood pressure


Waist circumference



We are grateful for our participants.

Author contributions

Authors’ roles: conception and design of the study: KDS and SYP. Collection, assembly, analysis and interpretation of data: KDS, EJP, WMS and SYP. Drafting the article or revising it critically for important intellectual content: KDS, EJP, WMS, and SYP. Final approval of the version to be submitted: KDS, EJP, SDS, WMS and SYP.


No financial or material support of any kind was received for the work described in this article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Akil L, Ahmad HA (2011) Relationships between obesity and cardiovascular diseases in four southern states and Colorado. J Health Care Poor Underserved 22:61–72. Google Scholar
  2. Arikawa AY, Thomas W, Schmitz KH, Kurzer MS (2011) Sixteen weeks of exercise reduces C-reactive protein levels in young women. Med Sci Sports Exerc 43:1002–1009. Google Scholar
  3. Beato GC, Ravelli MN, Crisp AH, de Oliveira MRM (2018) agreement between body composition assessed by bioelectrical impedance analysis and doubly labeled water in obese women submitted to bariatric surgery: body composition, BIA, and DLW. Obes Surg. Google Scholar
  4. Beck DT, Martin JS, Casey DP, Braith RW (2013) Exercise training reduces peripheral arterial stiffness and myocardial oxygen demand in young prehypertensive subjects. Am J Hypertens 26:1093–1102. Google Scholar
  5. Bharath LP, Choi WW, Cho JM, Skobodzinski AA, Wong A, Sweeney TE, Park SY (2018) Combined resistance and aerobic exercise training reduces insulin resistance and central adiposity in adolescent girls who are obese: randomized clinical trial. Eur J Appl Physiol 118:1653–1660. Google Scholar
  6. Brambilla P et al (2006) Crossvalidation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obes (Lond) 30:23–30. Google Scholar
  7. Campbell PT, Campbell KL, Wener MH, Wood BL, Potter JD, McTiernan A, Ulrich CM (2009) A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc 41:1533–1539. Google Scholar
  8. Chobanian AV et al (2003) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42:1206–1252. Google Scholar
  9. Chorin E, Hassidim A, Hartal M, Havakuk O, Flint N, Ziv-Baran T, Arbel Y (2015) Trends in adolescents obesity and the association between BMI and blood pressure: a cross-sectional study in 714,922 healthy teenagers. Am J Hypertens 28:1157–1163. Google Scholar
  10. Danesh J et al (2004) C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 350:1387–1397. Google Scholar
  11. Druwe IL, Sollome JJ, Sanchez-Soria P, Hardwick RN, Camenisch TD, Vaillancourt RR (2012) Arsenite activates NFkappaB through induction of C-reactive protein. Toxicol Appl Pharmacol 261:263–270. Google Scholar
  12. Edwards DG, Schofield RS, Lennon SL, Pierce GL, Nichols WW, Braith RW (2004) Effect of exercise training on endothelial function in men with coronary artery disease. Am J Cardiol 93:617–620. Google Scholar
  13. Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y (2017) Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci 13:851–863. Google Scholar
  14. Evans DL (1985) Cardiovascular adaptations to exercise and training. Vet Clin N Am Equine Pract 1:513–531Google Scholar
  15. Ewart CK, Young DR, Hagberg JM (1998) Effects of school-based aerobic exercise on blood pressure in adolescent girls at risk for hypertension. Am J Public Health 88:949–951Google Scholar
  16. Figueroa A, Park SY, Seo DY, Sanchez-Gonzalez MA, Baek YH (2011) Combined resistance and endurance exercise training improves arterial stiffness, blood pressure, and muscle strength in postmenopausal women. Menopause 18:980–984. Google Scholar
  17. Flegal KM, Ogden CL, Yanovski JA, Freedman DS, Shepherd JA, Graubard BI, Borrud LG (2010) High adiposity and high body mass index-for-age in US children and adolescents overall and by race-ethnic group. Am J Clin Nutr 91:1020–1026. Google Scholar
  18. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH (2007) Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 150:12 e12–17 e12. Google Scholar
  19. Giovannoni G, Land JM, Keir G, Thompson EJ, Heales SJ (1997) Adaptation of the nitrate reductase and Griess reaction methods for the measurement of serum nitrate plus nitrite levels. Ann Clin Biochem 34(Pt 2):193–198. Google Scholar
  20. Goto C et al (2007) Acute moderate-intensity exercise induces vasodilation through an increase in nitric oxide bioavailiability in humans. Am J Hypertens 20:825–830. Google Scholar
  21. Greene AS, Tonellato PJ, Lui J, Lombard JH, Cowley AW Jr (1989) Microvascular rarefaction and tissue vascular resistance in hypertension. Am J Physiol 256:H126–H131. Google Scholar
  22. Hage FG (2014) C-reactive protein and hypertension. J Hum Hypertens 28:410–415. Google Scholar
  23. Hakim AA et al (1999) Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation 100:9–13Google Scholar
  24. Hamer M, Chida Y, Stamatakis E (2010) Association of very highly elevated C-reactive protein concentration with cardiovascular events and all-cause mortality. Clin Chem 56:132–135. Google Scholar
  25. Harmse B, Kruger HS (2010) Significant differences between serum CRP levels in children in different categories of physical activity: the PLAY study. Cardiovasc J Afr 21:316–322Google Scholar
  26. Hodeib AA, Elsharawy TA, Fawzi HA (2010) Assessment of serum homocysteine, endothelin-1, and nitric oxide levels in behcet’s disease. Indian J Dermatol 55:215–220. Google Scholar
  27. Hvidt KN (2015) Blood pressure and arterial stiffness in obese children and adolescents. Dan Med J 62:1–22Google Scholar
  28. Jansen MA, Uiterwaal CS, Visseren FL, van der Ent CK, Grobbee DE, Dalmeijer GW (2016) Abdominal fat and blood pressure in healthy young children. J Hypertens 34:1796–1803. Google Scholar
  29. Kalkhoff RK, Hartz AH, Rupley D, Kissebah AH, Kelber S (1983) Relationship of body fat distribution to blood pressure, carbohydrate tolerance, and plasma lipids in healthy obese women. J Lab Clin Med 102:621–627Google Scholar
  30. Karelis AD, Chamberland G, Aubertin-Leheudre M, Duval C, Ecological mobility in A, Parkinson G (2013) Validation of a portable bioelectrical impedance analyzer for the assessment of body composition. Appl Physiol Nutr Metab 38:27–32 Google Scholar
  31. Kinlay S, Creager MA, Fukumoto M, Hikita H, Fang JC, Selwyn AP, Ganz P (2001) Endothelium-derived nitric oxide regulates arterial elasticity in human arteries in vivo. Hypertension 38:1049–1053Google Scholar
  32. Lakka TA et al (2005) Effect of exercise training on plasma levels of C-reactive protein in healthy adults: the HERITAGE Family Study. Eur Heart J 26:2018–2025. Google Scholar
  33. Lee SH, Scott SD, Pekas EJ, Lee S, Lee SH, Park SY (2018) Taekwondo training reduces blood catecholamine levels and arterial stiffness in postmenopausal women with stage-2 hypertension: randomized clinical trial. Clin Exp Hypertens. Google Scholar
  34. Liu J et al (2014) Effects of cardiorespiratory fitness on blood pressure trajectory with aging in a cohort of healthy men. J Am Coll Cardiol 64:1245–1253. Google Scholar
  35. Maeda S et al (2003) Aerobic exercise training reduces plasma endothelin-1 concentration in older women. J Appl Physiol (1985) 95:336–341. Google Scholar
  36. Masaki T, Yanagisawa M (1992) Endothelins. Essays Biochem 27:79–89Google Scholar
  37. Mayet J, Hughes A (2003) Cardiac and vascular pathophysiology in hypertension. Heart 89:1104–1109Google Scholar
  38. Miyatake N, Matsumoto S, Fujii M, Numata T (2008) Reducing waist circumference by at least 3 cm is recommended for improving metabolic syndrome in obese Japanese men. Diabetes Res Clin Pract 79:191–195. Google Scholar
  39. Morris NM, Udry JR (1980) Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adolesc 9:271–280. Google Scholar
  40. Myers J (2003) Cardiology patient pages. Exercise cardiovascular health. Circulation 107:e2–e5Google Scholar
  41. Ozer D, Duzgun I, Baltaci G, Karacan S, Colakoglu F (2011) The effects of rope or weighted rope jump training on strength, coordination and proprioception in adolescent female volleyball players. J Sports Med Phys Fit 51:211–219Google Scholar
  42. Park SY et al (2016) Impact of age on the vasodilatory function of human skeletal muscle feed arteries. Am J Physiol Heart Circ Physiol 310:H217–H225. Google Scholar
  43. Robbins LB, Pender NJ, Kazanis AS (2003) Barriers to physical activity perceived by adolescent girls. J Midwifery Womens Health 48:206–212Google Scholar
  44. Saijo Y, Kiyota N, Kawasaki Y, Miyazaki Y, Kashimura J, Fukuda M, Kishi R (2004) Relationship between C-reactive protein and visceral adipose tissue in healthy Japanese subjects. Diabetes Obes Metab 6:249–258. Google Scholar
  45. Sawka MN, Cheuvront SN, Carter R III (2005) Human water needs. Nutr Rev 63:S30–S39Google Scholar
  46. Seo DY et al (2012) Yoga training improves metabolic parameters in obese boys Korean. J Physiol Pharmacol 16:175–180. Google Scholar
  47. Singh U, Devaraj S, Vasquez-Vivar J, Jialal I (2007) C-reactive protein decreases endothelial nitric oxide synthase activity via uncoupling. J Mol Cell Cardiol 43:780–791. Google Scholar
  48. Son WM, Sung KD, Bharath LP, Choi KJ, Park SY (2017) Combined exercise training reduces blood pressure, arterial stiffness, and insulin resistance in obese prehypertensive adolescent girls. Clin Exp Hypertens 39:546–552. Google Scholar
  49. Strasser B, Arvandi M, Pasha EP, Haley AP, Stanforth P, Tanaka H (2015) Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 25:495–502. Google Scholar
  50. Tan S, Chen C, Sui M, Xue L, Wang J (2017) Exercise training improved body composition, cardiovascular function, and physical fitness of 5-year-old children with obesity or normal body. Mass Pediatr Exerc Sci 29:245–253. Google Scholar
  51. Taylor WC et al (1999) Physical activity among African American and Latino middle school girls: Consistent beliefs, expectations, and experiences across two sites. Women Health 30:67–82Google Scholar
  52. Venugopal SK, Devaraj S, Yuhanna I, Shaul P, Jialal I (2002) Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation 106:1439–1441Google Scholar
  53. Vlachopoulos C, Aznaouridis K, Terentes-Printzios D, Ioakeimidis N, Stefanadis C (2012) Prediction of cardiovascular events and all-cause mortality with brachial-ankle elasticity index: a systematic review and meta-analysis. Hypertension 60:556–562. Google Scholar
  54. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, Eber B (2004) Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 109:184–189. Google Scholar
  55. Withall J, Jago R, Fox KR (2011) Why some do but most don’t. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study. BMC Public Health 11:507. Google Scholar
  56. Yambe M et al (2007) Arterial stiffness and progression to hypertension in Japanese male subjects with high normal blood pressure. J Hypertens 25:87–93. Google Scholar
  57. You T, Berman DM, Ryan AS, Nicklas BJ (2004) Effects of hypocaloric diet and exercise training on inflammation and adipocyte lipolysis in obese postmenopausal women. J Clin Endocrinol Metab 89:1739–1746. Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ki-Dong Sung
    • 1
  • Elizabeth J. Pekas
    • 2
  • Steven D. Scott
    • 2
  • Won-Mok Son
    • 1
  • Song-Young Park
    • 1
    • 2
    Email author
  1. 1.Department of Physical EducationPusan National UniversityBusanSouth Korea
  2. 2.School of Health and KinesiologyUniversity of Nebraska at OmahaOmahaUSA

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