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Am J Cardiol. 2017 May 15;119(10):1616-1622. doi: 10.1016/j.amjcard.2017.02.011. Epub 2017 Mar 1.

Prevalence and Management of Systemic Hypertension in Athletes.

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Department of Cardiology, Institute of Sports Medicine and Science, Rome, Italy. Electronic address:
Department of Cardiology, Institute of Sports Medicine and Science, Rome, Italy.
Department of Internal Medicine, Hospital 'Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.


The aim of the present study was to evaluate the prevalence, determinants, and clinical management of systemic hypertension in a large cohort of competitive athletes: 2,040 consecutive athletes (aged 25 ± 6 years, 64% men) underwent clinical evaluation including blood test, electrocardiogram, exercise test, echocardiography, and ophthalmic evaluation. Sixty-five athletes (3%) were identified with hypertension (men = 57; 87%) including 5 with a secondary cause (thyroid dysfunction in 3, renal artery stenosis in 1, and drug induced in 1). The hypertensive athletes had greater left ventricular hypertrophy and showed more often a concentric pattern than normotensive ones. Moreover, they showed a mildly reduced physical performance and were characterized by a higher cardiovascular risk profile compared with normotensive athletes. Multivariate logistic regression analysis showed that family hypertension history (odds ratio 2.05; 95% confidence interval 1.21 to 3.49; p = 0.008) and body mass index (odds ratio 1.32; 95% confidence interval 1.23 to 1.40; p <0.001) were the strongest predictors of hypertension. Therapeutic intervention included successful lifestyle modification in 57 and required additional pharmacologic treatment in 3 with essential hypertension. Secondary hypertension was treated according to the underlying disorder. After a mean follow-up of 18 ± 6 months, all hypertensive athletes had achieved and maintained optimal control of the blood pressure, without restriction to sport participation. In conclusion, the prevalence of hypertension in athletes is low (3%) and largely related to family history and overweight. In the vast majority of hypertensives, lifestyle modifications were sufficient to achieve an optimal control of blood pressure values.

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