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Athletes and Hypertension

Schweiger, Victor, Niederseer, David, Schmied, Christian, Attenhofer-Jost, Christine, Caselli, Stefano·2021·Current Cardiology Reports

Abstract

Purpose of Review: We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. Recent Findings: An estimated quarter of the world’s population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual’s eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual’s risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Summary: Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.

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  1. •• Niebauer J, Börjesson M, Carre F, et al. Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2018;39:3664–71. This is the official document of the european society of preventive cardiology with guidelines regarding sport prescription in indviduals (athletes and non-athletes) with arterial hypertension. · DOI
  2. Berge HM, Isern CB, Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med. 2015;49(11):716–23. https://doi.org/10.1136/bjsports-2014-093976. · DOI
  3. Smolensky AV, Zolicheva SY, Mikhailova AV, et al. Morphofunctional characteristics of young rowers with increased blood pressure. Hum Physiol. 2010;36:462–5. https://doi.org/10.1134/S0362119710040122. · doi:10.1134/s0362119710040122
  4. Schleich KT, Smoot MK, Ernst ME. Hypertension in athletes and active populations. Curr Hypertens Rep. 2016;18:77. https://doi.org/10.1007/s11906-016-0685-y. · DOI
  5. Agrotou S, Karatzi K, Papamichael C, et al. Effects of chronic anaerobic training on markers of sub-clinical atherosclerosis. Hell J Cardiol. 2013;54:178–85.
  6. Williams PT. Lower prevalence of hypertension, hypercholesterolemia, and diabetes in marathoners. Med Sci Sports Exerc. 2009;41:523–9. https://doi.org/10.1249/MSS.0b013e31818c1752. · DOI
  7. Kim JH, Zafonte R, Pascuale-Leon A, et al. American-style football and cardiovascular health. J Am Heart Assoc. 2018;7:8620. https://doi.org/10.1161/JAHA.118.008620. · DOI
  8. Hedman K, Moneghetti KJ, Christle JW, et al. Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodelling. Heart. 2019;105:1223–30. https://doi.org/10.1136/heartjnl-2019-314815. · DOI
  9. Varga-Pintér B, Horváth P, Kneffel Z, et al. Resting blood pressure values of adult athletes. Kidney Blood Press Res. 2011;34:387–95. https://doi.org/10.1159/000327850. · DOI
  10. Guo J, Zhang X, Wang L, et al. Prevalence of metabolic syndrome and its components among Chinese professional athletes of strength sports with different body weight categories. PLoS One. 2013;8(11):e79758. https://doi.org/10.1371/journal.pone.0079758. · DOI
  11. Karpinos AR, Roumie CL, Nian H, et al. High prevalence of hypertension among collegiate football athletes. Circ Cardiovasc Qual Outcomes. 2013;6:716–23. https://doi.org/10.1161/CIRCOUTCOMES.113.000463. · DOI
  12. Williams PT. A cohort study of incident hypertension in relation to changes in vigorous physical activity in men and women. J Hypertens. 2008;26:1085–93. https://doi.org/10.1097/HJH.0b013e3282fb81dc. · DOI
  13. Gheshlaghi F, Piri-Ardakani MR, Masoumi GR, et al. Cardiovascular manifestations of anabolic steroids in association with demographic variables in body building athletes. J Res Med Sci. 2015;20:165–8.
  14. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104. https://doi.org/10.1093/eurheartj/ehy339. · DOI · Paper page
  15. Caselli S, Vaquer Sequì A, Lemme E, et al. Prevalence and management of systemic hypertension in athletes. Am J Cardiol. 2017;119:1616–22. https://doi.org/10.1016/j.amjcard.2017.02.011. · DOI
  16. Niebauer J, Börjesson M, Carre F, et al. Brief recommendations for participation in competitive sports of athletes with arterial hypertension: Summary of a Position Statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol. 2019;26:1549–55. https://doi.org/10.1177/2047487319852807. · DOI
  17. Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician. 2002;66:445.
  18. Kouidi E. White coat hypertension detected during screening of male adolescent athletes. Am J Hypertens. 1999;12:223–6. https://doi.org/10.1016/S0895-7061(98)00186-1. · DOI
  19. Trachsel LD, Carlen F, Brugger N, et al. Masked hypertension and cardiac remodeling in middle-aged endurance athletes. J Hypertens. 2015;33:1276–83. https://doi.org/10.1097/HJH.0000000000000558. · DOI
  20. Berge HM, Andersen TE, Solberg EE, Steine K. High ambulatory blood pressure in male professional football players. Br J Sports Med. 2013;47:521–5. https://doi.org/10.1136/bjsports-2013-092354. · DOI
  21. Shim CY, Ha JW, Park S, et al. Exaggerated blood pressure response to exercise is associated with augmented rise of angiotensin II during exercise. J Am Coll Cardiol. 2008;52:287–92. https://doi.org/10.1016/j.jacc.2008.03.052. · DOI
  22. Pressler A, Jähnig A, Halle M, Haller B. Blood pressure response to maximal dynamic exercise testing in an athletic population. J Hypertens. 2018;36:1803–9. https://doi.org/10.1097/HJH.0000000000001791. · DOI · Paper page
  23. MacDougall JD, Tuxen D, Sale DG, et al. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol. 1985;58:785–90. https://doi.org/10.1152/jappl.1985.58.3.785. · DOI · Paper page
  24. Abel EL, Kruger ML. Longevity of major league baseball players. Res Sport Med. 2005;13:1–5. https://doi.org/10.1080/15438620590922031. · DOI
  25. Antero-Jacquemin J, Desgorces FD, Dor F, et al. Row for your life: A century of mortality follow-up of French olympic rowers. PLoS One. 2014;9(11):e113362. https://doi.org/10.1371/journal.pone.0113362. · DOI
  26. Clarke PM, Walter SJ, Hayen A, et al. Survival of the fittest: Retrospective cohort study of the longevity of Olympic medallists in the modern era. BMJ. 2012;345. https://doi.org/10.1136/bmj.e8308. · DOI
  27. Laukkanen JA, Kunutsor SK, Ozemek C, et al. Cross-country skiing and running’s association with cardiovascular events and all-cause mortality: A review of the evidence. Prog Cardiovasc Dis. 2019;62:505–14. https://doi.org/10.1016/j.pcad.2019.09.001. · DOI
  28. Bäckmand H, Kujala U, Sarna S, Kaprio J. Former athletes’ health-related lifestyle behaviours and self-rated health in late adulthood. Int J Sports Med. 2010;31:751–8. https://doi.org/10.1055/s-0030-1255109. · DOI
  29. Pate RR, Trost SG, Levin S, Dowda M. Sports participation and health-related behaviors among US youth. Arch Pediatr Adolesc Med. 2000;154:904–11. https://doi.org/10.1001/archpedi.154.9.904. · DOI · Paper page
  30. Nattiv A, Puffer JC, Green GA. Lifestyles and health risks of collegiate athletes. Clin J Sport Med. 1997;7:262–72. https://doi.org/10.1097/00042752-199710000-00004. · DOI
  31. Runacres A, Mackintosh KA, McNarry MA. Health consequences of an elite sporting career: long-term detriment or long-term gain? A meta-analysis of 165,000 former athletes. Sport Med. 2021;51:289–301. https://doi.org/10.1007/s40279-020-01379-5. · DOI
  32. Kujala UM. Hospital care in later life among former world-class finnish athletes. JAMA J Am Med Assoc. 1996;276:216. https://doi.org/10.1001/jama.1996.03540030050031. · DOI
  33. Herman CW, Conlon ASC, Rubenfire M, et al. The very high premature mortality rate among active professional wrestlers is primarily due to cardiovascular disease. PLoS One. 2014;9:109945. https://doi.org/10.1371/journal.pone.0109945. · DOI
  34. Howard DPJ, Banerjee A, Fairhead JF, et al. Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the oxford vascular study. Circulation. 2013;127:2031–7. https://doi.org/10.1161/CIRCULATIONAHA.112.000483. · DOI · Paper page
  35. Zwiers R, Zantvoord FWA, Engelaer FM, et al. Mortality in former Olympic athletes: retrospective cohort analysis. BMJ. 2012;345. https://doi.org/10.1136/bmj.e7456. · DOI
  36. Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993;25:237–44. https://doi.org/10.1249/00005768-199302000-00013. · DOI · Paper page
  37. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52. https://doi.org/10.1161/01.HYP.0000107251.49515.c2. · DOI · Paper page
  38. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13. https://doi.org/10.1016/S0140-6736(02)11911-8. · DOI · Paper page
  39. Schmidt-Trucksäss A, Schmid A, Dörr B, Huonker M. The relationship of left ventricular to femoral artery structure in male athletes. Med Sci Sport Exerc. 2003;35:214–9. https://doi.org/10.1249/01.MSS.0000048637.26711.93. · DOI
  40. Syed MA. Carotid-wall intima-media thickness and cardiovascular events. Cardiol Rev. 2011;27:213. https://doi.org/10.1056/nejmoa1012592. · DOI · Paper page
  41. Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: A meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8. https://doi.org/10.1161/HYPERTENSIONAHA.111.177071. · DOI · Paper page
  42. Mannakkara NN, Sharma S. Sudden cardiac death in athletes. Trends Urol Men’s Heal. 2020;11:10. https://doi.org/10.1002/tre.758. · DOI
  43. Bille K, Figueiras D, Schamasch P, et al. Sudden cardiac death in athletes: The Lausanne Recommendations. Eur J Cardiovasc Prev Rehabil. 2006;13:859–75. https://doi.org/10.1097/01.hjr.0000238397.50341.4a. · DOI · Paper page
  44. •• Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease: The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC). Eur Heart J. 2021;42:17–96. Must read document including recommendation for sport activity in several cardiovascular conditions. · DOI · Paper page
  45. Pelliccia A, Adami PE, Quattrini F, et al. Are Olympic athletes free from cardiovascular diseases? Systematic investigation in 2352 participants from Athens 2004 to Sochi 2014. Br J Sports Med. 2017;51:238–43. https://doi.org/10.1136/bjsports-2016-096961. · DOI
  46. Ljungqvist A, Jenoure P, Engebretsen L, et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med. 2009;43:631–43. https://doi.org/10.1136/bjsm.2009.064394. · DOI · Paper page
  47. Sprafka JM, Strickland D, Gomez-Marin O, Prineas RJ. The effect of cuff size on blood pressure measurement in adults. Epidemiology. 1991;2:214–7. https://doi.org/10.1097/00001648-199105000-00010. · DOI
  48. Lurbe E, Agabiti-Rosei E, Cruickshank JK, et al. European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920. https://doi.org/10.1097/HJH.0000000000001039. · DOI · Paper page
  49. O’Connor FG, Meyering CD, Patel R, Oriscello RP. Hypertension, athletes, and the sports physician: Implications of JNC VII, the fourth report, and the 36th Bethesda Conference guidelines. Curr Sports Med Rep. 2007;6:80–4. https://doi.org/10.1007/BF02941147. · doi:10.1007/bf02941147
  50. Niederseer D, Rossi VA, Kissel C, et al. Role of echocardiography in screening and evaluation of athletes. Heart. 2021;107:270–6. https://doi.org/10.1136/heartjnl-2020-317996. · DOI
  51. Kaplan NM, Gidding SS, Pickering TG, Wright JT. Task force 5: Systemic hypertension. In: Journal of the American College of Cardiology. Elsevier USA; 2005. pp. 1346–1348. · DOI
  52. Pelliccia A, Zipes DP, Maron BJ. Bethesda Conference #36 and the European Society of Cardiology Consensus Recommendations revisited. A comparison of U.S. and European criteria for eligibility and disqualification of competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol. 2008;52:1990–6. https://doi.org/10.1016/j.jacc.2008.08.055. · DOI · Paper page
  53. Black HR, Sica D, Ferdinand K, White WB. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 6: hypertension: a scientific statement from the American Heart Association and the American College of Cardiology. Circulation. 2015;132:e298–302. https://doi.org/10.1161/CIR.0000000000000242. · DOI
  54. Pescatello LS, Franklin BA, Fagard R, et al. Exercise and hypertension. Med Sci Sport Exerc. 2004;36:533–53. https://doi.org/10.1249/01.MSS.0000115224.88514.3A. · DOI · Paper page
  55. Whelton PK. Effects of oral potassium on blood pressure. JAMA. 1997;277:1624. https://doi.org/10.1001/jama.1997.03540440058033. · DOI · Paper page
  56. Chick TW, Halperin AK, Gacek EM. The effect of antihypertensive medications on exercise performance: A review. Med Sci Sports Exerc. 1988;20:447–54. https://doi.org/10.1249/00005768-198810000-00004. · DOI
  57. Marcadet DM, Blanc AS, Lopez AA, et al. Efficacy and tolerance of LA 50 mg nicardipine in hypertensive athletes. Arch Mal Coeur Vaiss. 1991;84:1569–74.
  58. Wang P, Fedoruk MN, Rupert JL. Keeping pace with ACE: Are ACE inhibitors and angiotensin II type 1 receptor antagonists potential doping agents? Sport Med. 2008;38:1065–79. · DOI
  59. Pelto H. Hypertensive medications in competitive athletes. Curr Sports Med Rep. 2017;16:45–9. https://doi.org/10.1249/JSR.0000000000000325. · DOI
  60. Oliveira LPJ, Lawless CE. Hypertension update and cardiovascular risk reduction in physically active individuals and athletes. Phys Sportsmed. 2010;38:11–20. https://doi.org/10.3810/psm.2010.04.1757. · DOI
  61. Nilsson S, Westheim AS. Effect of α1-adrenoceptor blockade on maximal vo2 and endurance capacity in well-trained athletic hypertensive men. Am J Hypertens. 1994;7:603–8. https://doi.org/10.1093/ajh/7.7.603. · doi:10.1093/ajh/7.7.603
  62. Tesch PA. Exercise performance and β-blockade. Sport Med An Int J Appl Med Sci Sport Exerc. 1985;2:389–412. https://doi.org/10.2165/00007256-198502060-00002. · DOI
  63. Matelot D, Schnell F, Kervio G, et al. Athlete’s bradycardia may be a multifactorial mechanism. J Appl Pphysiol. 2013;114(12):1755–6. https://doi.org/10.1152/japplphysiol.00307.2013. · doi:10.1152/japplphysiol.00307.2013
  64. Locatelli F, Del Vecchio L, Andrulli S, Colzani S. Role of combination therapy with ACE inhibitors and calcium channel blockers in renal protection. In: Kidney International, Supplement. Blackwell Publishing Inc.; 2002. pp. S53–S60. · doi:10.1046/j.1523-1755.62.s82.11.x
  65. Houston MC. Alpha1-blocker combination therapy for hypertension. An option to try when traditional methods fail. Postgrad Med. 1998;104:167–87. https://doi.org/10.3810/pgm.1998.09.581. · doi:10.3810/pgm.1998.09.581
  66. Li DK, Yang C, Andrade S, et al. Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: A retrospective cohort study. BMJ. 2011;343:d5931. https://doi.org/10.1136/bmj.d5931. · DOI
  67. Tso J, Hollowed C, Liu C, et al. Nonsteroidal anti-inflammatory drugs and cardiovascular risk in American football. Med Sci Sports Exerc. 2020;52:2522–8. https://doi.org/10.1249/MSS.0000000000002404. · DOI
  68. Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011;19:184–91. · DOI
  69. Rasmussen JJ, Schou M, Madsen PL, et al. Increased blood pressure and aortic stiffness among abusers of anabolic androgenic steroids: potential effect of suppressed natriuretic peptides in plasma? J Hypertens. 2018;36:277–85. https://doi.org/10.1097/HJH.0000000000001546. · DOI
  70. Lundby C, Thomsen JJ, Boushel R, et al. Erythropoietin treatment elevates haemoglobin concentration by increasing red cell volume and depressing plasma volume. J Physiol. 2007;578:309–14. https://doi.org/10.1113/JPHYSIOL.2006.122689. · DOI
  71. Berglund B, Ekblom B. Effect of recombinant human erythropoietin treatment on blood pressure and some haematological parameters in healthy men. J Intern Med. 1991;229:125–30. https://doi.org/10.1111/J.1365-2796.1991.TB00319.X. · DOI
  72. Fazio S, Cittadini A, Sabatini D, et al. Growth hormone and heart performance A novel mechanism of cardiac wall stress regulation in humans. Eur Heart J. 1997;18:340–7. · DOI
  73. Johannsson G, Mårin P, Lönn L, et al. Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure. J Clin Endocrinol Metab. 1997;82:727–34. https://doi.org/10.1210/JCEM.82.3.3809. · DOI · Paper page
  74. Peeters BM, Lantz CD, Mayhew JL. Effect of oral creatine monohydrate and creatine phosphate supplementation on maximal strength indices, body composition, and blood pressure. J Strength Cond Res. 1999;13:3–9.
  75. Gimblet CJ, Pellinger TK, LaManca JJ, et al. Effects of acute creatine monohydrate supplementation on arterial stiffness and muscle oxygen saturation in young men. Adv Orthop Sport Med. 2021. https://doi.org/10.37722/AOASM.2021401. · DOI
  76. Mihic S, MacDonald JR, McKenzie S, Tarnopolsky MA. Acute creatine loading increases fat-free mass, but does not affect blood pressure, plasma creatinine, or CK activity in men and women. Med Sci Sports Exerc. 2000;32:291–6. https://doi.org/10.1097/00005768-200002000-00007. · DOI · Paper page
  77. Wilens TE, Hammerness PG, Biederman J, et al. Blood pressure changes associated with medication treatment of adults with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2005;66:253–9. https://doi.org/10.4088/JCP.V66N0215. · DOI
  78. Mick E, McManus DD, Goldberg RJ. Meta-analysis of increased heart rate and blood pressure associated with CNS stimulant treatment of ADHD in adults. Eur Neuropsychopharmacol. 2013;23:534–41. https://doi.org/10.1016/J.EURONEURO.2012.06.011. · DOI

Cited by

Metadata

Authors
Schweiger, V., Niederseer, D., Schmied, C., Attenhofer-Jost, C., & Caselli, S.
Venue
Current Cardiology Reports
Published
2021-10-16
Volume
23
Issue
12
ISSN
  • 1523-3782
  • 1534-3170
Cited by
27
References
8
Language
en
Licence
Funders
Universität Zürich

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