Arterial hypertension and blood pressure response to exercise in athletes

Objective: Arterial hypertension is one of the most important risk factors for cardiovascular disease and the most common pathological finding in the examination of athletes. On the other hand, physical activity leads to a reduction in blood pressure and is thus an essential part of a regimen in the treatment of hypertension. People who wish to engage in sport at the competitive level should be pre screened by a stress test. A number of those examined have resting hypertension and a part has an exaggerated response to exercise. Our aim was to determine what proportion of the tested athletes had each hypertensive phenotypes and exercise BP hyperresponsiveness. Furthermore, we wanted to compare the prevalence of arterial hypertension between different types of sporting activity - mixed, endurance, strength and skill. Design and method: We retrospectively analyzed data from 1,733 adult athletes who underwent stress testing at two sports medicine centers between 2019 and 2023. The mean age was 24.9 years, 69% of the subjects were male and the relative performance was on average 4.08 W/kg. Clinical data at rest and during exercise were measured and recorded. Subsequently, the data were statistically processed. Results: A total of 431 (24.9%) subjects met the criteria for arterial hypertension when resting blood pressure was measured. Z 182 (10.5%) had isolated systolic hypertension and 104 (6%) had isolated 19 (1.1%) subjects had exertional hypertension. Elevated diastolic blood pressure occurs significantly more frequently in athletes with skill or strength type sports than in athletes with mixed type sports (24.0% and 24.2% vs. The hypertensive response to exercise occurs significantly more frequently in athletes with strength-type sports than in athletes with mixed-type sports (4.5% vs. 0.7%, p = 0.006). Conclusions: The higher incidence of resting and exertional arterial hypertension in specific types of sports should lead to more intensive diagnosis and care for these specific types of athletes. The definition of exertional pressure hyperreaction is currently inconsistent. Longer follow-up of individuals with borderline and pathological values could lead to more effective indication for testing and subsequent treatment and regimen measures.