Updated Blood Pressure Guidelines: Implications for Athletes

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. J Am Coll Cardiol. 2015;66:2393–7. https://doi.org/10.1016/j.jacc.2015.09.038.

Article  PubMed  Google Scholar 

U.S. Department of Health and Human Services. Physical activity guidelines for Americans, 2nd edition. 2018. Retrieved September 2, 2021, from https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf.

Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13-5. https://doi.org/10.1161/HYP.0000000000000065. Epub 2017 Nov 13. Erratum in: Hypertension. 2018 Jun;71(6):e140-e144. PMID: 29133356.

Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens. 1995;8:657–65.

CAS  Article  Google Scholar 

Gray L, Lee IM, Sesso HD, Batty GD. Blood pressure in early adulthood, hypertension in middle age, and future cardiovascular disease mortality: HAHS (Harvard Alumni Health Study). J Am Coll Cardiol. 2011;58:2396–403.

Article  Google Scholar 

Maron BJ, Epstein SE, Roberts WC. Causes of sudden death in competitive athletes. J Am Coll Cardiol. 1986;7(1):204–14. https://doi.org/10.1016/S0735-1097(86)80283-2.

CAS  Article  PubMed  Google Scholar 

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:e79758.

CAS  Article  Google Scholar 

Pelliccia A, Kinoshita N, Pisicchio C, et al. Long-term clinical consequences of intense, uninterrupted endurance training in Olympic athletes. J Am Coll Cardiol. 2010;55:1619–25.

Article  Google Scholar 

Shapero K, Deluca J, Contursi M, Wasfy M, Weiner RB, Lewis GD, et al. Cardiovascular risk and disease among masters endurance athletes: insights from the Boston MASTER (Masters Athletes Survey To Evaluate Risk) Initiative. Sports Med Open. 2016;2:29. https://doi.org/10.1186/s40798-016-0053-0.

Article  PubMed  PubMed Central  Google Scholar 

• Berge HM, Isern CB, Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med. 2015;49:716–23. This paper highlights the limitations in the data with respect to the prevalence of hypertension in athletes.

Karpinos AR, Roumie CL, Nian H, Diamond AB, Rothman RL. High prevalence of hypertension among collegiate football athletes. Circ Cardiovasc Qual Outcomes. 2013;6(6):716–23. https://doi.org/10.1161/CIRCOUTCOMES.113.000463. Epub 2013 Nov 12. PMID: 24221829; PMCID: PMC3975920.

Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

CAS  Article  Google Scholar 

Weiner RB, Wang F, Isaacs SK, Malhotra R, Berkstresser B, Kim JH, Hutter AM Jr, Picard MH, Wang TJ, Baggish AL. Blood pressure and left ventricular hypertrophy during American-style football participation. Circulation. 2013;128(5):524–31. https://doi.org/10.1161/CIRCULATIONAHA.113.003522. PMID: 23897848.

Article  PubMed  Google Scholar 

• Kim JH, et al. Weight gain, hypertension, and the emergence of a maladaptive cardiovascular phenotype among US football players. JAMA Cardiol. 2019;4(12):1221–9. Important study evaluating correlations of weight gain and elevated blood pressure in football players and subsequent development of pathological cardiovascular changes over the course of their collegiate careers.

Article  Google Scholar 

Tucker AM, Vogel RA, Lincoln AE, Dunn RE, Ahrensfield DC, Allen TW, Castle LW, Heyer RA, Pellman EJ, Strollo PJ Jr, Wilson PW, Yates AP. Prevalence of cardiovascular disease risk factors among National Football League players. JAMA. 2009;301(20):2111–9. https://doi.org/10.1001/jama.2009.716. PMID: 19470988.

CAS  Article  PubMed  Google Scholar 

•• Caselli S, Vaquer Sequì A, Lemme E, Quattrini F, Milan A, D'Ascenzi F, Spataro A, Pelliccia A. Prevalence and management of systemic hypertension in athletes. Am J Cardiol. 2017;119(10):1616–22. https://doi.org/10.1016/j.amjcard.2017.02.011. Epub 2017 Mar 1. PMID: 28325568. Large and comprehensive study on the prevalence and determinants of hypertension in competitive athletes.

• Hedman K, Moneghetti KJ, Christle JW, et al. Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodeling. Heart. 2019;105:1223–30. This study highlighted the findings that elevated blood pressure on preparticipation examination may have clinical relevance given findings of reduction in diastolic indices in those with higher blood pressures.

• Petek BJ, Drezner JA, Harmon KG. Prevalence of elevated blood pressure and risk factors for hypertension in college athletes. Clin J Sport Med. 2022;32(1):e74–82. https://doi.org/10.1097/JSM.0000000000000876. Study showing increase in athletes meeting criteria for hypertension using the updated blood pressure guidelines.

Article  PubMed  Google Scholar 

Shah AB, Torguson R, Alexander K, Khan U, Zhang C, Fisher C, Hoffman MD, Sedgley M, Lincoln A, Baggish AL. Cardiovascular risk among ultra-endurance runners. J Sports Med Phys Fitness. 2021. https://doi.org/10.23736/S0022-4707.21.11903-6. Epub ahead of print. PMID: 33586930.

Le VV, Mitiku T, Sungar G, et al. The blood pressure response to dynamic exercise testing: a systematic review. Prog Cardiovasc Dis. 2008;51:135–60.

Article  Google Scholar 

•• Caselli S, Segui AV, Quattrini F, Di Gacinto B, Milan A, Assorgi R, Verdile L, Spataro A, Pelliccia A. Upper normal values of blood pressure response to exercise in Olympic athletes. Am Heart J. 2016;177:120–8, ISSN 0002–8703. https://doi.org/10.1016/j.ahj.2016.04.020. Important study evaluating the blood pressure response to exercise in healthy elite athletes.

MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol. 1985;58(3):785–90. https://doi.org/10.1152/jappl.1985.58.3.785. PMID: 3980383.

CAS  Article  PubMed  Google Scholar 

Hatzaras I, Tranquilli M, Coady M, Barrett PM, Bible J, Elefteriades JA. Weight lifting and aortic dissection: more evidence for a connection. Cardiology. 2007;107(2):103–6. https://doi.org/10.1159/000094530. Epub 2006 Jul 14 PMID: 16847387.

CAS  Article  PubMed  Google Scholar 

Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.

Article  Google Scholar 

Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2000;35:838–43.

CAS  Article  Google Scholar 

Pescatello LS, Fargo AE, Leach CN Jr, Scherzer HH. Short-term effect of dynamic exercise on arterial blood pressure. Circulation. 1991;83:1557–61.

CAS  Article  Google Scholar 

Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA, American College of Sports Medicine. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36(3):533–53. https://doi.org/10.1249/01.mss.0000115224.88514.3a. PMID: 15076798.

Article  PubMed  Google Scholar 

Cornelissen VA, Fagard RH. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors. Hypertension. 2005;46(4):667–75. https://doi.org/10.1161/01.HYP.0000184225.05629.51. Epub 2005 Sep 12 PMID: 16157788.

CAS  Article  PubMed  Google Scholar 

Parr JW. Attention-deficit hyperactivity disorder and the athlete: new advances and understanding. Clin Sports Med. 2011;30:591–610. https://doi.org/10.1016/j.csm.2011.03.007.

Article  PubMed  Google Scholar 

Han DH, McDuff D, Thompson D, Hitchcock ME, Reardon CL, Hainline B. Attention-deficit/hyperactivity disorder in elite athletes: a narrative review. Br J Sports Med. 2019;53(12):741–5. https://doi.org/10.1136/bjsports-2019-100713. Epub 2019 May 16 PMID: 31097459.

Article  PubMed  Google Scholar 

Suzic Lazic J, Dikic N, Radivojevic N, Mazic S, Radovanovic D, Mitrovic N, et al. Dietary supplements and medications in elite sport – polypharmacy or real need? Scand J Med Sci Sports. 2011;21:260–7.

CAS  Article  Google Scholar 

Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. 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(40):3664–71. https://doi.org/10.1093/eurheartj/ehy511. PMID: 30165596.

Article  PubMed  Google Scholar 

Phillips CL, O’Driscoll DM. Hypertension and obstructive sleep apnea. Nat Sci Sleep. 2013;5:43–52. https://doi.org/10.2147/NSS.S34841.

Article  PubMed  PubMed Central  Google Scholar 

Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. 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(40):3664–71. https://doi.org/10.1093/eurheartj/ehy511.

Article  PubMed  Google Scholar 

Maron BJ, Pelliccia A, Spataro A, Granata M. Reduction in left ventricular wall thickness after deconditioning in highly trained Olympic athletes. Br Heart J. 1993;69:125–8.

CAS  Article  Google Scholar 

Engel DJ, Schwartz A, Homma S. Athletic cardiac remodeling in US professional basketball players. JAMA Cardiol. 2016;1(1):80–7. https://doi.org/10.1001/jamacardio.2015.0252.

Article  PubMed  Google Scholar 

Martinez MW, Kim JH, Shah AB, Phelan D, Emery MS, Wasfy MM, Fernandez AB, Bunch TJ, Dean P, Danielian A, Krishnan S, Baggish AL, Eijsvogels TMH, Chung EH, Levine BD. Exercise-induced cardiovascular adaptations and approach to exercise and cardiovascular disease: JACC state-of-the-art review. J Am Coll Cardiol. 2021;78(14):1453–70. https://doi.org/10.1016/j.jacc.2021.08.003. PMID: 34593128.

Article  PubMed  Google Scholar 

Smith VE, Schulman P, Karimeddini MK, White WB, Meeran MK, Katz AM. Rapid ventricular filling in left ventricular hypertrophy, II: pathologic hypertrophy. J Am Coll Cardiol. 1985;5:869–74.

CAS  Article  Google Scholar 

WADA. The World Anti-Doping Code International Standard Prohibited List 2022. Montreal, Canada: WADA. 2022. https://www.wada-ama.org/sites/default/files/2022-01/2022list_final_en_0.pdf. Accessed 20 May 2022.

Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician. 2002;66:445–52.

PubMed  Google Scholar 

Chick TW, Halperin AK, Gacek EM. The effect of anti-hypertensive medications on exercise performance: a review. Med Sci Sports Exerc. 1988;20:447–54.

CAS  Article  Google Scholar 

Grant AJ, Kanwal A, Shah AB. Swimming: what the sports cardiologist should know. Curr Treat Options Cardio Med. 2020;22:70. https://doi.org/10.1007/s11936-020-00876-0.

Article  Google Scholar 

Schnohr P, O’Keefe JH, Marott JL, Lange P, Jensen GB. Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol. 2015;65(5):411–9. https://doi.org/10.1016/j.jacc.2014.11.023. PMID: 25660917.

Article  PubMed  Google Scholar 

Roberts WO, Schwartz RS, Garberich RF, Carlson S, Knickelbine T, Schwartz JG, Peichel G, Lesser JR, Wickstrom K, Harris KM. Fifty men, 3510 marathons, cardiac risk factors, and coronary artery calcium scores. Med Sci Sports Exerc. 2017;49(12):2369–73. https://doi.org/10.1249/MSS.0000000000001373. PMID: 28719492.

Article  PubMed  Google Scholar 

Centers for Disease Control and Prevention. High blood pressure. 2021. https://www.cdc.gov/bloodpressure/facts.htm#:~:text=Nearly%20half%20of%20adults%20in,are%20taking%20medication%20for%20hypertension. Accessed 25 May 2022

Albuquerque FN, Kuniyoshi FH, Calvin AD, Sierra-Johnson J, Romero-Corral A, Lopez-Jimenez F, George CF, Rapoport DM, Vogel RA, Khandheria B, Goldman ME, Roberts A, Somers VK. Sleep-disordered breathing, hypertension, and obesity in retired National Football League players. J Am Coll Cardiol. 2010;56(17):1432–3. https://doi.org/10.1016/j.jacc.2010.03.099.PMID:20947003;PMCID:PMC3039309.

Article  PubMed  PubMed Central  Google Scholar 

留言 (0)

沒有登入
gif