Exercise Hypertension in Athletes
<b>Background:</b> An exaggerated blood pressure response (EBPR) during exercise testing is not well defined, and several blood pressure thresholds are used in different studies and recommended in different guidelines. <b>Methods:</b> Competitive athletes of any age without k...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4870 |
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| author | Karsten Keller Katharina Hartung Luis del Castillo Carillo Julia Treiber Florian Stock Chantal Schröder Florian Hugenschmidt Birgit Friedmann-Bette |
| author_facet | Karsten Keller Katharina Hartung Luis del Castillo Carillo Julia Treiber Florian Stock Chantal Schröder Florian Hugenschmidt Birgit Friedmann-Bette |
| author_sort | Karsten Keller |
| collection | DOAJ |
| description | <b>Background:</b> An exaggerated blood pressure response (EBPR) during exercise testing is not well defined, and several blood pressure thresholds are used in different studies and recommended in different guidelines. <b>Methods:</b> Competitive athletes of any age without known arterial hypertension who presented for preparticipation screening were included in the present study and categorized for EBPR according to American Heart Association (AHA), European Society of Cardiology (ESC), and American College of Sports Medicine (ACSM) guidelines as well as the systolic blood pressure/MET slope method. <b>Results:</b> Overall, 1137 athletes (mean age 21 years; 34.7% females) without known arterial hypertension were included April 2020–October 2021. Among them, 19.6%, 15.0%, and 6.8% were diagnosed EBPR according to ESC, AHA, and ACSM guidelines, respectively. Left ventricular hypertrophy (LVH) was detected in 20.5% of the athletes and was approximately two-fold more frequent in athletes with EBPR than in those without. While EBPR according to AHA (OR 2.35 [95%CI 1.66–3.33], <i>p</i> < 0.001) and ACSM guidelines (OR 1.81 [95%CI 1.05–3.09], <i>p</i> = 0.031) was independently (of age and sex) associated with LVH, EBPR defined according to ESC guidelines (OR 1.49 [95%CI 1.00–2.23], <i>p</i> = 0.051) was not. In adult athletes, only AHA guidelines (OR 1.96 [95%CI 1.32–2.90], <i>p</i> = 0.001) and systolic blood pressure/MET slope method (OR 1.73 [95%CI 1.08–2.78], <i>p</i> = 0.023) were independently predictive for LVH. <b>Conclusions:</b> Diverging guidelines exist for the screening regarding EBPR. In competitive athletes, the prevalence of EBPR was highest when applying the ESC (19.6%) and lowest using the ACSM guidelines (6.8%). An association of EBPR with LVH in adult athletes, independently of age and sex, was only found when the AHA guideline or the systolic blood pressure/MET slope method was applied. |
| first_indexed | 2024-03-09T04:16:17Z |
| format | Article |
| id | doaj.art-33d9c074ad9b4ca7930dd1058878d8b9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:16:17Z |
| publishDate | 2022-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-33d9c074ad9b4ca7930dd1058878d8b92023-12-03T13:53:10ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116487010.3390/jcm11164870Exercise Hypertension in AthletesKarsten Keller0Katharina Hartung1Luis del Castillo Carillo2Julia Treiber3Florian Stock4Chantal Schröder5Florian Hugenschmidt6Birgit Friedmann-Bette7Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, GermanyMedical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany<b>Background:</b> An exaggerated blood pressure response (EBPR) during exercise testing is not well defined, and several blood pressure thresholds are used in different studies and recommended in different guidelines. <b>Methods:</b> Competitive athletes of any age without known arterial hypertension who presented for preparticipation screening were included in the present study and categorized for EBPR according to American Heart Association (AHA), European Society of Cardiology (ESC), and American College of Sports Medicine (ACSM) guidelines as well as the systolic blood pressure/MET slope method. <b>Results:</b> Overall, 1137 athletes (mean age 21 years; 34.7% females) without known arterial hypertension were included April 2020–October 2021. Among them, 19.6%, 15.0%, and 6.8% were diagnosed EBPR according to ESC, AHA, and ACSM guidelines, respectively. Left ventricular hypertrophy (LVH) was detected in 20.5% of the athletes and was approximately two-fold more frequent in athletes with EBPR than in those without. While EBPR according to AHA (OR 2.35 [95%CI 1.66–3.33], <i>p</i> < 0.001) and ACSM guidelines (OR 1.81 [95%CI 1.05–3.09], <i>p</i> = 0.031) was independently (of age and sex) associated with LVH, EBPR defined according to ESC guidelines (OR 1.49 [95%CI 1.00–2.23], <i>p</i> = 0.051) was not. In adult athletes, only AHA guidelines (OR 1.96 [95%CI 1.32–2.90], <i>p</i> = 0.001) and systolic blood pressure/MET slope method (OR 1.73 [95%CI 1.08–2.78], <i>p</i> = 0.023) were independently predictive for LVH. <b>Conclusions:</b> Diverging guidelines exist for the screening regarding EBPR. In competitive athletes, the prevalence of EBPR was highest when applying the ESC (19.6%) and lowest using the ACSM guidelines (6.8%). An association of EBPR with LVH in adult athletes, independently of age and sex, was only found when the AHA guideline or the systolic blood pressure/MET slope method was applied.https://www.mdpi.com/2077-0383/11/16/4870arterial hypertensionexercise hypertensionblood pressureexercise testing |
| spellingShingle | Karsten Keller Katharina Hartung Luis del Castillo Carillo Julia Treiber Florian Stock Chantal Schröder Florian Hugenschmidt Birgit Friedmann-Bette Exercise Hypertension in Athletes Journal of Clinical Medicine arterial hypertension exercise hypertension blood pressure exercise testing |
| title | Exercise Hypertension in Athletes |
| title_full | Exercise Hypertension in Athletes |
| title_fullStr | Exercise Hypertension in Athletes |
| title_full_unstemmed | Exercise Hypertension in Athletes |
| title_short | Exercise Hypertension in Athletes |
| title_sort | exercise hypertension in athletes |
| topic | arterial hypertension exercise hypertension blood pressure exercise testing |
| url | https://www.mdpi.com/2077-0383/11/16/4870 |
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