Exercise and the Hypertensive Athlete

Exercise considerations in hypertension, obesity, and dyslipidemia

Sports medicine practitioners who care for a wide array of athletes and active individuals will consistently face issues regarding chronic cardiovascular diseases and their associated risk factors. Among these, hypertension, obesity, and dyslipidemia are common clinical conditions that may be encountered even amongst elite caliber athletes. Consequently, those entrusted with the care of this active population must recognize the presence of these disorders and feel comfortable with their management in the face of continued sports or exercise participation. This article reviews the pathophysiology of these conditions as they relate to athletes and outlines the value of continued exercise in the management of each of these entities while addressing the specific and unique treatment needs of active individuals.

The benefits of exercise for women

This article describes the benefits of exercise, including why exercise improves blood pressure control, how it may reduce the risk for cancer, and increase mental health, and how it may improve bone mineral density. The article also explores the gender-independent and gender-specific benefits of exercise for women.

Hypertension in athletes and active patients: tailoring treatment to the patient

Understanding the hemodynamic responses to exercise in normotensive and hypertensive persons allows physicians to effectively treat hypertension in active people and athletes. If lifestyle modifications such as weight loss and moderation of sodium intake along with continued exercise are not effective, drug therapy can be added. Nonselective beta-blockers and diuretics may impair performance; cardioselective beta-1 blockers, ACE inhibitors, calcium channel blockers, and alpha-1 blockers are less likely to hinder exercise. Therapy tailored to the type and intensity of a patient's exercise and the stage of hypertension may allow him or her to participate safely without compromising performance.

Management of Hypertension

In brief Current recommendations for brief managing mild to very severe high blood pressure need to be adapted for the special concerns of physically active patients. First-line treatment involves dietary changes, smoking cessation, and aerobic exercise. The next step is to add drug therapy, and diuretics and beta-blockers are the initial drugs of choice because of their proven long-term efficacy. Diuretics may, however, produce hypokalemia or dehydration, and beta- blockers may cause hyperkalemia, reduce exercise capacity, or increase perceived exertion. Other antihypertensive agents may be preferable in specific situations.