Risk of hypertension in athletes

Hypertension in athletes

Athlete hypertension can be a considerable problem if not treated well as it can lead to more cardiac complication and may affect the future of the athlete.

During athletes check up, if the blood pressure is more than 142/92 mm/hg, 80% of them will develop sustained hypertension.

What is the most important risk or consequence of hypertension in athletes?

The answer simply is left ventricular hypertrophy (LVH) and its long term danger.

Some people get some exaggerated BP response to exertion like stress test when the SBP goes up over 210 mm hg for men and over 190 mm hg for women but there is no widely accepted definition of exertion hypertension.
However, subject with an excessive rise in BP during exercise are candidate to be hypertensive. But that does not mean to ask those athlete to stop sport, but they are asked to keep an eye on their BP because they may get clear hypertension later on.
Athletes with mild hypertension without other cardiovascular risk factor can continue their sport once BP is controlled.
Whereas athletes with grade II – III High BP and after control the BP are not eligible for heavy sports especially competitive one.

What the difference between “Athletes heart” and pathologic “concentric hypertrophy” of HBP by echocardiography?

In athletes heart physiologic eccentric hypertrophy: LV (left Ventricle) mass increased with normal or increased fractional mid-wall shortening, high LV volume but LV wall still normal or minimal thickening.
In pathologic concentric hypertrophy of HBP : LV chamber size is normal or reduced and the LV wall thickened, here we should limit participation until BP is normalised.

Recommendation of The 36^th Bethesda Conference for Hypertensive Athletes

They should undergo full assessment of BP, and should have echocardiography if BP is more than 140/90 mm hg , If there is LV hypertrophy beyond that seen with athletes heart, they should limit participation until BP is well controlled .

Athletes with stage I they need lifestyle modification and follow up monthly.
Athletes with stage II should refrain particularly from high static sport until their BP is well controlled by either lifestyle modification or drug therapy.

We also seriously recommend a regular cardiac check up for athletes. And more seriously recommend a check up, if you suffer from any sort of hypertension, particularly if you are planning a return to sport activity after a stop.

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