Substantial Portion of Young Athletes at Risk For Hypertension

A significant prevalence of elevated blood pressure (BP) measurements was found among young athletes during community heart screenings, according to research presented during ACC's Care of the Athletic Heart conference, held June 6 to 8 in Washington, DC.

Aneeq Malik, MD, et al., sought to assess the prevalence of hypertension among young athletes and evaluate the impact of the 2017 ACC/AHA guideline on high BP on diagnosis rates using data collected from preventive heart screenings.

Among the 1,429 participants screened, 1,196 had recorded BP measurements. The cohort consisted of 717 male (59.9%), 477 female (39.9%) and two gender nonbinary (0.2%) participants. Their ages ranged from 10 to 31 years, and the median age was 15 years.

Results showed that 21.3% of participants overall met the definition of pre-hypertension, 13.2% had Stage I hypertension and 8% were diagnosed with Stage II hypertension. Of note, the male, vs. female, participants, had a higher prevalence of Stage I hypertension (17.3% vs. 7.1%) and Stage II hypertension (10.9% vs. 3.8%). The highest rate of hypertension, at 28.3%, was seen in young athletes who participated in multiple sports. Of single sports, basketball and football players had the highest rates of hypertension (27.6% and 27.1% respectively).

Several factors could explain the higher rates of hypertension among athletes in specific sports, such as individualized training routines unique to each sport, dietary habits for specific sports or positions, variations in average body size, and social determinants of health, note the authors. Furthermore, they note the results of this study are consistent with previous studies that found that sports with higher levels of static exercise were associated with elevated BP measurements. Football and basketball involve moderate levels of static exercise, which could contribute to the higher hypertension rates.

"Despite being perceived as a generally healthy population, young athletes are not immune to heart disease, including elevated BP," said Malik. "The findings emphasize that screening for hypertension should be a routine part of sports physicals and that confirmatory testing is needed to accurately diagnose the condition."

"Once hypertension is confirmed, educating young athletes and their families about the diagnosis becomes paramount. Appropriate lifestyle interventions, such as dietary adjustments and counseling on supplement use, increased physical activity, healthy sleep behavior and stress management, should be implemented along with routine monitoring," Malik said.

ACC's Care of the Athletic Heart course, led by Chair and Vice Chair, respectively, Meagan Wasfy, MD, MPH, FACC, and Jeffrey Hsu, MD, PhD, FACC, features top sports cardiology experts discussing the latest advances in the rapidly evolving field of sports cardiology, as well as fundamental cardiovascular diagnostic and management strategies and treatment options in the field, providing clinicians with guideline-driven, practical, cardiovascular care strategies to improve the care of athlete patients.

Additional clinical cases and poster abstracts being presented during the conference include:

  • The Prevalence of Hypertension in Young Athletes: A Community-Based Screening Analysis
  • Social Disparities, Experiences with Discrimination, and Cardiovascular Phenotypes in Black and White Collegiate American-Style Football Players
  • Exercise-Induced Ventricular Fibrillation Cardiac Arrest in a Firefighter Using Intramuscular Testosterone with Segmental Pulmonary Embolism and Coronary Arterial Thrombosis
  • Heart Paradox: A Case of Ventricular Fibrillation in Prescence of Commotio Cordis and Hypertrophic Cardiomyopathy

Learn more about ACC's Care of the Athletic Heart course here.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Sports and Exercise Cardiology, Vascular Medicine, SCD/Ventricular Arrhythmias, Hypertension

Keywords: Blood Pressure, Prehypertension, Social Determinants of Health, Ventricular Fibrillation, Hypertension, Sports, Athletes, Cardiomyopathy, Hypertrophic, Hypertrophic Cardiomyopathy, Pulmonary Embolism

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