High ambulatory blood pressure in male professional football players

Abstract

Background No data exist on ambulatory blood pressure (ABP) in athletes. Objectives To identify ABP and examine recommended follow-up of high office blood pressure (OBP) in male professional football players and secondary study indicators of sympathetic activity. Methods Players with high OBP (cases) from a previous screening of 594 players (n=28) were matched for age and ethnicity with players with optimal OBP (controls). High ABP was defined as a mean of ≥135/85 mm Hg during daytime and ≥120/75 mm Hg during night-time. The players replied to questions regarding follow-up of high OBP. High night-time ABP and lack of nocturnal dip (≤10% decline in average BP) were taken as indicators of increased sympathetic activity.Results 26 cases and 26 controls, mean age 28±4 years, were included. 15 (58%) of the cases had sustained hypertension and 11 (42%) white coat hypertension. Among the controls, 17 (65%) had normotension and 9 (35%) masked hypertension. ABP during night-time was high in 23 (88%) of the cases and in 16 (64%) of the controls, and nocturnal dip was absent in 9 (35%) and 11 (42%), respectively. 10 (38%) of the cases had no follow-up of high OBP. Conclusions More than one-third of the players with optimal OBP had masked hypertension during daytime and more than half of all players had high ABP during night-time, which are novel findings in athletes. Together with the reduced nocturnal dip, this might indicate increased sympathetic activity. Follow-up of high OBP after preparticipation screening is random and should be organised.

Masked hypertension and cardiac remodeling in middle-aged endurance athletes

“…In our sample of middle-aged endurance athletes, the proportion of athletes with masked hypertension was substantially higher (38%) than estimates from the general population (8-20%) [8], but comparable to male professional football players [20]. Importantly, the prevalence of masked hypertension depends on the definition.…”

“…Although exercise training in general may prevent hypertension by positively affecting endothelial function and arterial stiffness [22,23], repetitive episodes of high-intensity strength or endurance exercise may contribute to a rise in BP, possibly by an increased sympathetic activity [6,20]. However, our study was not intended to demonstrate a causal relationship between endurance sports practice and masked hypertension.…”

Physical activity and exercise lower blood pressure in individuals with hypertension: narrative review of 27 RCTs

“…The prevalence figures of hypertension in athletes varies greatly between studies, being 7% for male professional football (soccer) players59 and 19% for collegiate (US) football players 60. A recent systematic review61 showed a prevalence of hypertension in the range of 0 to 45% for different populations, possibly attributable to various quality of methodology used in available studies.…”

Blood pressure and hypertension in athletes: a systematic review

“…As several studies have demonstrated increased left ventricular mass and increased left atrium size in athletes,12 it is possible that high BP may be a contributing factor13 14 that may also link to the increased risk of atrial fibrillation in endurance athletes 15–17. Hence, there is increasing interest in BP in athletes 14 18 19. BP measurement during preparticipation screening of athletes should be performed according to ‘best clinical care’,20 as outlined in the European Society of Cardiology's guidelines, with hypertension defined as systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg after repeated measurements 21.…”