Hipertansiyon ve Spor
Özet
Hipertansiyon, dünya nüfusunun yaklaşık %25’ini etkileyen bir sağlık sorunudur (1). Ayrıca, hipertansiyonun artmış kardiyovasküler morbidite ve mortalite ile ilişkilidir (2). Epidemiyolojik çalışmalar, fiziksel aktivite ile kan basıncı düzeyleri arasında ters bir ilişki olduğunu bildirmiş ve egzersizin sistolik ve diyastolik kan basıncını düşürdüğünü göstermiştir (3). Genel nüfusta olduğu gibi sporcularda da hipertansiyon yaygın bir problemdir. Yapılan sağlık taramalarında sporcular sıklıkla hipertansiyon tanısı alır. Bu durum rekabetçi ve güç sporlarıyla ilgilenen sporcuların sıklıkla yaptıkları spordan dışlanabileceği anlamına gelir. Sporcuların düzenli fiziksel aktivitede bulunması kardiyovasküler sağlık üzerinde olumlu etki yapar. Ancak, yüksek yoğunluklu rekabetçi egzersizin kardiyovasküler hastalığı olan bireylerde ciddi morbidite ve hatta ani kardiyak ölüm riskini de beraberinde getirir (2).
Genç nüfusun herhangi bir fiziksel aktiviteye katılması teşvik edilmelidir ancak spor yapan birey hipertansifse, spora bağlı gelişebilecek sağlık sorunlarını ve ani kardiyak ölüm riskini de bilmesi gerekmektedir. Spora katılım öncesi gençlerin mevcut sağlık durumu, güvenli bir şekilde katılabileceği spor türünü de etkiler.
Özellikle arteriyel hipertansiyon, uzun vadede sol ventrikül hipertrofisine yol açar ve koroner arter hastalığı için bir risk faktörüdür. Ayrıca, kan basıncındaki akut artış, aterosklerotik plakların parçalanmasına neden olabilir ve miyokard enfarktüsü veya serebrovasküler olaylara yol açabilir.
Referanslar
Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2018 Oct 21;39(40):3664-3671.
Berge HM, Isern CB, Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med. 2015 Jun;49(11):716-23.
Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, Urbina E, Van Horn LV, Zachariah JP; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; and Stroke Council. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association. Circulation. 2016 Sep 20;134(12):e236-55.
Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR, Kimball TR, Knilans TK, Nixon PA, Rhodes J, Yetman AT; American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation. 2006 Apr 18;113(15):1905-20.
Braden DS, Strong WB. Cardiovascular responses to exercise in childhood. Am J Dis Child. 1990 Nov;144(11):1255-60.
Seals DR, Washburn RA, Hanson PG, Painter PL, Nagle FJ. Increased cardiovascular response to static contraction of larger muscle groups. J Appl Physiol Respir Environ Exerc Physiol. 1983 Feb;54(2):434-7.
de Moraes AC, Carvalho HB, Siani A, Barba G, Veidebaum T, Tornaritis M, Molnar D, Ahrens W, Wirsik N, De Henauw S, Mårild S, Lissner L, Konstabel K, Pitsiladis Y, Moreno LA; IDEFICS consortium. Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: High blood pressure, lifestyle and children. Int J Cardiol. 2015 Feb 1;180:165-70.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104.
Caselli S, Vaquer Sequì A, Lemme E, Quattrini F, Milan A, D'Ascenzi F, Spataro A, Pelliccia A. Prevalence and Management of Systemic Hypertension in Athletes. Am J Cardiol. 2017 May 15;119(10):1616-1622.
Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician. 2002 Aug 1;66(3):445-52.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM; SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep;140(3):e20171904. doi: 10.1542/peds.2017-1904. Epub 2017 Aug 21. Erratum in: Pediatrics. 2017 Nov 30;: Erratum in: Pediatrics. 2018 Sep;142(3): PMID: 28827377.
Caselli S, Serdoz A, Mango F, Lemme E, Vaquer Seguì A, Milan A, Attenhofer Jost C, Schmied C, Spataro A, Pelliccia A. High blood pressure response to exercise predicts future development of hypertension in young athletes. Eur Heart J. 2019 Jan 1;40(1):62-68.
MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol (1985). 1985 Mar;58(3):785-90.
Pressler A, Jähnig A, Halle M, Haller B. Blood pressure response to maximal dynamic exercise testing in an athletic population. J Hypertens. 2018 Sep;36(9):1803-1809.
Laukkanen JA, Kunutsor SK, Ozemek C, Mäkikallio T, Lee DC, Wisloff U, Lavie CJ. Cross-country skiing and running's association with cardiovascular events and all-cause mortality: A review of the evidence. Prog Cardiovasc Dis. 2019 Nov-Dec;62(6):505-514.
Pate RR, Trost SG, Levin S, Dowda M. Sports participation and health-related behaviors among US youth. Arch Pediatr Adolesc Med. 2000 Sep;154(9):904-11.
Nattiv A, Puffer JC. Lifestyles and health risks of collegiate athletes. J Fam Pract. 1991 Dec;33(6):585-90.
Bäckmand H, Kujala U, Sarna S, Kaprio J. Former athletes' health-related lifestyle behaviours and self-rated health in late adulthood. Int J Sports Med. 2010 Oct;31(10):751-8.
Runacres A, Mackintosh KA, McNarry MA. Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes. Sports Med. 2021 Feb;51(2):289-301.
Herman CW, Conlon AS, Rubenfire M, Burghardt AR, McGregor SJ. The very high premature mortality rate among active professional wrestlers is primarily due to cardiovascular disease. PLoS One. 2014 Nov 5;9(11):e109945.
Howard DP, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM; Oxford Vascular Study. Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study. Circulation. 2013 May 21;127(20):2031-7.
Zwiers R, Zantvoord FW, Engelaer FM, van Bodegom D, van der Ouderaa FJ, Westendorp RG. Mortality in former Olympic athletes: retrospective cohort analysis. BMJ. 2012 Dec 13;345:e7456.
Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993 Feb;25(2):237-44.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13.
Schmidt-Trucksäss A, Schmid A, Dörr B, Huonker M. The relationship of left ventricular to femoral artery structure in male athletes. Med Sci Sports Exerc. 2003 Feb;35(2):214-9; discussion 220.
Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA, D'Agostino RB Sr. Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 2011 Jul 21;365(3):213-21.
Daimee UA, Lande MB, Tang W, Tu XM, Veazie P, Bisognano JD, Block R, Teeters JC. Blood pressure and left ventricular mass index in healthy adolescents. Blood Press Monit. 2017 Feb;22(1):48-50.
Drazner MH, Rame JE, Marino EK, Gottdiener JS, Kitzman DW, Gardin JM, Manolio TA, Dries DL, Siscovick DS. Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. J Am Coll Cardiol. 2004 Jun 16;43(12):2207-15.
Jing L, Nevius CD, Friday CM, Suever JD, Pulenthiran A, Mejia-Spiegeler A, Kirchner HL, Cochran WJ, Wehner GJ, Chishti AS, Haggerty CM, Fornwalt BK. Ambulatory systolic blood pressure and obesity are independently associated with left ventricular hypertrophic remodeling in children. J Cardiovasc Magn Reson. 2017 Nov 9;19(1):86.
Utomi V, Oxborough D, Whyte GP, Somauroo J, Sharma S, Shave R, Atkinson G, George K. Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. Heart. 2013 Dec;99(23):1727-33.
Kouidi E, Fahadidou-Tsiligiroglou A, Tassoulas E, Deligiannis A, Coats A. White coat hypertension detected during screening of male adolescent athletes. Am J Hypertens. 1999 Feb;12(2 Pt 1):223-6.
Lin J, Wang F, Weiner RB, DeLuca JR, Wasfy MM, Berkstresser B, Lewis GD, Hutter AM Jr, Picard MH, Baggish AL. Blood Pressure and LV Remodeling Among American-Style Football Players. JACC Cardiovasc Imaging. 2016 Dec;9(12):1367-1376.
Pelliccia A, Maron MS, Maron BJ. Assessment of left ventricular hypertrophy in a trained athlete: differential diagnosis of physiologic athlete's heart from pathologic hypertrophy. Prog Cardiovasc Dis. 2012 Mar-Apr;54(5):387-96.
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Graham Stuart A, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021 Jan 1;42(1):17-96.
American Academy of Family Physicians, American College of Sports Medicine, American Medical Society. PPE Preparticipation Physical Evaluation monograph, 4th ed, Bernhardt DT and Roberts WO (Ed), American Academy of Pediatrics, 2010.
Campbell RM, Douglas PS, Eidem BW, Lai WW, Lopez L, Sachdeva R (2014) ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/ SCMR/SOPE 2014 appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 64(19):2039–2060
Black HR, Sica D, Ferdinand K, White WB. Eligibility and dis qualification recommendations for competitive athletes with car diovascular abnormalities: task force 6: hypertension: a scientific statement from the American Heart Association and the American College of Cardiology. Circulation. 2015;132:e298–302.
McCambridge TM, Benjamin HJ, Brenner JS, Cappetta CT, Demorest RA, Gregory AJ, Halstead M, Koutures CG, LaBella CR, Martin S, Rice SG, Council on Sports Medicine and Fitness (2010) Athletic participation by children and adolescents who have systemic hypertension. Pediatrics. 125(6):1287–1294
Chick TW, Halperin AK, Gacek EM. The effect of antihyper tensive medications on exercise performance: A review. Med Sci Sports Exerc. 1988;20:447–54.
Oliveira LPJ, Lawless CE. Hypertension update and cardiovas cular risk reduction in physically active individuals and athletes. Phys Sportsmed. 2010;38:11–20.
Nilsson S, Westheim AS. Effect of α1-adrenoceptor blockade on maximal vo2 and endurance capacity in well-trained athletic hypertensive men. Am J Hypertens. 1994;7:603–8.
Schweiger V, Niederseer D, Schmied C, Attenhofer-Jost C, Caselli S. Athletes and Hypertension. Curr Cardiol Rep. 2021 Oct 16;23(12):176.
Tesch PA. Exercise performance and β-blockade. Sport Med An Int J Appl Med Sci Sport Exerc. 1985;2:389–412.
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Peeters BM, Lantz CD, Mayhew JL. Effect of oral creatine monohydrate and creatine phosphate supplementation on maxi mal strength indices, body composition, and blood pressure. J Strength Cond Res. 1999;13:3–9.
Referanslar
Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2018 Oct 21;39(40):3664-3671.
Berge HM, Isern CB, Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med. 2015 Jun;49(11):716-23.
Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, Urbina E, Van Horn LV, Zachariah JP; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; and Stroke Council. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association. Circulation. 2016 Sep 20;134(12):e236-55.
Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR, Kimball TR, Knilans TK, Nixon PA, Rhodes J, Yetman AT; American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation. 2006 Apr 18;113(15):1905-20.
Braden DS, Strong WB. Cardiovascular responses to exercise in childhood. Am J Dis Child. 1990 Nov;144(11):1255-60.
Seals DR, Washburn RA, Hanson PG, Painter PL, Nagle FJ. Increased cardiovascular response to static contraction of larger muscle groups. J Appl Physiol Respir Environ Exerc Physiol. 1983 Feb;54(2):434-7.
de Moraes AC, Carvalho HB, Siani A, Barba G, Veidebaum T, Tornaritis M, Molnar D, Ahrens W, Wirsik N, De Henauw S, Mårild S, Lissner L, Konstabel K, Pitsiladis Y, Moreno LA; IDEFICS consortium. Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: High blood pressure, lifestyle and children. Int J Cardiol. 2015 Feb 1;180:165-70.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104.
Caselli S, Vaquer Sequì A, Lemme E, Quattrini F, Milan A, D'Ascenzi F, Spataro A, Pelliccia A. Prevalence and Management of Systemic Hypertension in Athletes. Am J Cardiol. 2017 May 15;119(10):1616-1622.
Niedfeldt MW. Managing hypertension in athletes and physically active patients. Am Fam Physician. 2002 Aug 1;66(3):445-52.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM; SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep;140(3):e20171904. doi: 10.1542/peds.2017-1904. Epub 2017 Aug 21. Erratum in: Pediatrics. 2017 Nov 30;: Erratum in: Pediatrics. 2018 Sep;142(3): PMID: 28827377.
Caselli S, Serdoz A, Mango F, Lemme E, Vaquer Seguì A, Milan A, Attenhofer Jost C, Schmied C, Spataro A, Pelliccia A. High blood pressure response to exercise predicts future development of hypertension in young athletes. Eur Heart J. 2019 Jan 1;40(1):62-68.
MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol (1985). 1985 Mar;58(3):785-90.
Pressler A, Jähnig A, Halle M, Haller B. Blood pressure response to maximal dynamic exercise testing in an athletic population. J Hypertens. 2018 Sep;36(9):1803-1809.
Laukkanen JA, Kunutsor SK, Ozemek C, Mäkikallio T, Lee DC, Wisloff U, Lavie CJ. Cross-country skiing and running's association with cardiovascular events and all-cause mortality: A review of the evidence. Prog Cardiovasc Dis. 2019 Nov-Dec;62(6):505-514.
Pate RR, Trost SG, Levin S, Dowda M. Sports participation and health-related behaviors among US youth. Arch Pediatr Adolesc Med. 2000 Sep;154(9):904-11.
Nattiv A, Puffer JC. Lifestyles and health risks of collegiate athletes. J Fam Pract. 1991 Dec;33(6):585-90.
Bäckmand H, Kujala U, Sarna S, Kaprio J. Former athletes' health-related lifestyle behaviours and self-rated health in late adulthood. Int J Sports Med. 2010 Oct;31(10):751-8.
Runacres A, Mackintosh KA, McNarry MA. Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes. Sports Med. 2021 Feb;51(2):289-301.
Herman CW, Conlon AS, Rubenfire M, Burghardt AR, McGregor SJ. The very high premature mortality rate among active professional wrestlers is primarily due to cardiovascular disease. PLoS One. 2014 Nov 5;9(11):e109945.
Howard DP, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM; Oxford Vascular Study. Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study. Circulation. 2013 May 21;127(20):2031-7.
Zwiers R, Zantvoord FW, Engelaer FM, van Bodegom D, van der Ouderaa FJ, Westendorp RG. Mortality in former Olympic athletes: retrospective cohort analysis. BMJ. 2012 Dec 13;345:e7456.
Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993 Feb;25(2):237-44.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13.
Schmidt-Trucksäss A, Schmid A, Dörr B, Huonker M. The relationship of left ventricular to femoral artery structure in male athletes. Med Sci Sports Exerc. 2003 Feb;35(2):214-9; discussion 220.
Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA, D'Agostino RB Sr. Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 2011 Jul 21;365(3):213-21.
Daimee UA, Lande MB, Tang W, Tu XM, Veazie P, Bisognano JD, Block R, Teeters JC. Blood pressure and left ventricular mass index in healthy adolescents. Blood Press Monit. 2017 Feb;22(1):48-50.
Drazner MH, Rame JE, Marino EK, Gottdiener JS, Kitzman DW, Gardin JM, Manolio TA, Dries DL, Siscovick DS. Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. J Am Coll Cardiol. 2004 Jun 16;43(12):2207-15.
Jing L, Nevius CD, Friday CM, Suever JD, Pulenthiran A, Mejia-Spiegeler A, Kirchner HL, Cochran WJ, Wehner GJ, Chishti AS, Haggerty CM, Fornwalt BK. Ambulatory systolic blood pressure and obesity are independently associated with left ventricular hypertrophic remodeling in children. J Cardiovasc Magn Reson. 2017 Nov 9;19(1):86.
Utomi V, Oxborough D, Whyte GP, Somauroo J, Sharma S, Shave R, Atkinson G, George K. Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. Heart. 2013 Dec;99(23):1727-33.
Kouidi E, Fahadidou-Tsiligiroglou A, Tassoulas E, Deligiannis A, Coats A. White coat hypertension detected during screening of male adolescent athletes. Am J Hypertens. 1999 Feb;12(2 Pt 1):223-6.
Lin J, Wang F, Weiner RB, DeLuca JR, Wasfy MM, Berkstresser B, Lewis GD, Hutter AM Jr, Picard MH, Baggish AL. Blood Pressure and LV Remodeling Among American-Style Football Players. JACC Cardiovasc Imaging. 2016 Dec;9(12):1367-1376.
Pelliccia A, Maron MS, Maron BJ. Assessment of left ventricular hypertrophy in a trained athlete: differential diagnosis of physiologic athlete's heart from pathologic hypertrophy. Prog Cardiovasc Dis. 2012 Mar-Apr;54(5):387-96.
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Graham Stuart A, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021 Jan 1;42(1):17-96.
American Academy of Family Physicians, American College of Sports Medicine, American Medical Society. PPE Preparticipation Physical Evaluation monograph, 4th ed, Bernhardt DT and Roberts WO (Ed), American Academy of Pediatrics, 2010.
Campbell RM, Douglas PS, Eidem BW, Lai WW, Lopez L, Sachdeva R (2014) ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/ SCMR/SOPE 2014 appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 64(19):2039–2060
Black HR, Sica D, Ferdinand K, White WB. Eligibility and dis qualification recommendations for competitive athletes with car diovascular abnormalities: task force 6: hypertension: a scientific statement from the American Heart Association and the American College of Cardiology. Circulation. 2015;132:e298–302.
McCambridge TM, Benjamin HJ, Brenner JS, Cappetta CT, Demorest RA, Gregory AJ, Halstead M, Koutures CG, LaBella CR, Martin S, Rice SG, Council on Sports Medicine and Fitness (2010) Athletic participation by children and adolescents who have systemic hypertension. Pediatrics. 125(6):1287–1294
Chick TW, Halperin AK, Gacek EM. The effect of antihyper tensive medications on exercise performance: A review. Med Sci Sports Exerc. 1988;20:447–54.
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