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In screening of young athletes, one-third have elevated BP
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Among young athletes receiving preparticipation evaluations, approximately one-third had BP levels exceeding the threshold for hypertension according to U.S. guidelines, researchers reported.
The researchers also found that male sex, BMI, height and left ventricular mass-to-volume ratio were associated with elevated systolic BP.
Kristofer Hedman, MD, PhD, and colleagues investigated BP in athletes at preparticipation evaluation in the context of recently updated U.S. and European guidelines while determining the relationship between BP and LV remodeling.
“Physical activity is beneficial for primary prevention of hypertension, although smaller previous reports have described relatively high blood pressure in competitive athletes of varying age and sport disciplines,” Hedman, senior lecturer and physiotherapist in the department of medicine, division of cardiovascular medicine, Stanford Cardiovascular Institute at Stanford University, and colleagues wrote.
The researchers examined the data of athletes aged 13 to 35 years who underwent preparticipation evaluations facilitated by the Stanford Sports Cardiology program. Resting BP was measured in both arms and repeated once if there was a BP reading of 140/90 mm Hg or more.
A separate cohort of athletes having preparticipation evaluation echocardiography were examined to determine the relationship between BP and LV remodeling — defined as LV mass, mass-to-volume ratio and sphericity index — and LV function, Hedman and colleagues wrote.
In the first cohort (n = 2,733; 65% male), the researchers found 34.3% of the athletes surpassed U.S. hypertension thresholds.
Male sex (beta = 3.17; 95% CI, 2.19-4.16) and BMI (beta = 0.8; 95% CI, 0.69-0.9) were the strongest independent correlates of systolic BP, Hedman and colleagues wrote. Height (beta = 0.25; 95% CI, 0.21-0.29) was also determined to have a strong relationship to systolic BP.
Of participants in the second cohort (n = 304; aged 17-26 years; 86% male), systolic BP independently correlated with LV mass-to-volume ratio (beta = 0.002; P = .001), the researchers wrote.
LV longitudinal strain was equal across the BP categories in the group, and early diastolic relaxation was related to elevated BP, Hedman and colleagues wrote.
“This is important to acknowledge when current guidelines for blood pressure measurements and recommendations in athletic populations are revised,” the researchers wrote. “High blood pressure at preparticipation evaluation may, however, represent a clinically relevant phenomenon, and careful considerations are warranted in choosing the appropriate blood pressure level where follow-up is warranted.” – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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