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Steffen K, Bahr R, Clarsen B, Fossan B, Fredriksen H, Gjelsvik H, Haugvad L, Hoksrud AF, Iversen E, Koivisto-Mørk A, Moen E, Røstad V, Reier-Nilsen T, Torgalsen T, Berge HM. Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: what did we learn? Br J Sports Med 2024; 58:826-835. [PMID: 38744502 PMCID: PMC11287577 DOI: 10.1136/bjsports-2023-107942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. METHODS We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. RESULTS The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. CONCLUSION Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.
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Affiliation(s)
- Kathrin Steffen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Roald Bahr
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bjørn Fossan
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Fredriksen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Gjelsvik
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Lars Haugvad
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Erik Iversen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Ellen Moen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Vibeke Røstad
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | | | - Thomas Torgalsen
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
| | - Hilde Moseby Berge
- Olympiatoppen, The Norwegian Olympic Training Center, Oslo, Norway
- Oslo Sports Trauma Research Center, Insitute of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Okoh AK, Amponsah MKD, Cheffet-Walsh S, Patel M, Carfagno D, Linton D, Dimeff R, Braunreiter D, Harrington P, Brennan FH, Kavinsky C, Everett M, Park B, Gunnarsson M, Snowden S, Mootz L, Koepnick T, Wheeler J, Clarke SE, Prince H, Sannino A, Grayburn P, Rice EL. Prevalence of Cardiovascular Disease and Risk Factors Among Former National Football League Players. J Am Coll Cardiol 2024; 83:1827-1837. [PMID: 38593943 DOI: 10.1016/j.jacc.2024.03.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited. OBJECTIVES HUDDLE (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms) aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events. METHODS HUDDLE was a multicity, cross-sectional study of NFL alumni and family members aged 50 years and older. Subjects reported their health history and participated in CVD education and screening (blood pressure, electrocardiogram, and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30 days postscreening to review results and recommendations. This analysis focuses on former NFL athletes. RESULTS Of 498 participants screened, 57.2% (N = 285) were former NFL players, the majority of whom were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants, 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that hypertension was a significant predictor of clinically relevant structural abnormalities on TTE. CONCLUSIONS HUDDLE identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by hypertension, affirming the role of TTE for CVD screening in this population aged older than 50 years. (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms [HUDDLE]; NCT05009589).
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Affiliation(s)
| | | | | | - Mehul Patel
- Sutherland Cardiology Clinic, Methodist LeBonheur Healthcare, Germantown, Tennessee, USA
| | - David Carfagno
- Scottsdale Sports Medicine Institute, Scottsdale, Arizona, USA
| | | | | | - David Braunreiter
- Houston Methodist Orthopedics & Sports Medicine, Sugarland, Texas, USA
| | | | - Fred H Brennan
- Turley Family Health Center, University of South Florida, BayCare Health System, Clearwater, Florida, USA
| | | | | | | | | | | | - Lidia Mootz
- Edwards Lifesciences, Irvine, California, USA
| | | | | | | | | | - Anna Sannino
- Baylor Scott & White Research Institute, Dallas, Texas, USA
| | - Paul Grayburn
- Baylor Scott & White Research Institute, Dallas, Texas, USA
| | - E Lee Rice
- San Diego Sports Medicine & Family Health Center, Lifewellness Institute, San Diego, California, USA.
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3
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Most A, Kraushaar L, Dörr O, Keranov S, Hoelscher S, Weber R, Akdogan E, Groesser V, Husain-Syed F, Nef H, Hamm CW, Bauer P. Association of central blood pressure with an exaggerated blood pressure response to exercise among elite athletes. Eur J Appl Physiol 2024; 124:1239-1252. [PMID: 37987923 PMCID: PMC10955016 DOI: 10.1007/s00421-023-05353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The systolic blood pressure/workload (SBP/MET) slope was recently reported to be a reliable parameter to identify an exaggerated blood pressure response (eBPR) in the normal population and in athletes. However, it is unclear whether an eBPR correlates with central blood pressure (CBP) and vascular function in elite athletes. METHODS We examined 618 healthy male elite athletes (age 25.8 ± 5.1 years) of mixed sports with a standardized maximum exercise test. CBP and vascular function were measured non-invasively with a validated oscillometric device. The SBP/MET slope was calculated and the threshold for an eBPR was set at > 6.2 mmHg/MET. Two groups were defined according to ≤ 6.2 and > 6.2 mmHg/MET, and associations of CBP and vascular function with the SBP/MET slope were compared for each group. RESULTS Athletes with an eBPR (n = 180, 29%) displayed a significantly higher systolic CBP (102.9 ± 7.5 vs. 100 ± 7.7 mmHg, p = 0.001) but a lower absolute (295 ± 58 vs. 384 ± 68 W, p < 0.001) and relative workload (3.14 ± 0.54 vs. 4.27 ± 1.1 W/kg, p < 0.001) compared with athletes with a normal SBP/MET slope (n = 438, 71%). Systolic CBP was positively associated with the SBP/MET slope (r = 0.243, p < 0.001). In multiple logistic regression analyses, systolic CBP (odds ratio [OR] 1.099, 95% confidence interval [CI] 1.045-1.155, p < 0.001) and left atrial volume index (LAVI) (OR 1.282, CI 1.095-1.501, p = 0.002) were independent predictors of an eBPR. CONCLUSION Systolic CBP and LAVI were independent predictors of an eBPR. An eBPR was further associated with a lower performance level, highlighting the influence of vascular function on the BPR and performance of male elite athletes.
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Affiliation(s)
- Astrid Most
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Stanislav Keranov
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Sophie Hoelscher
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Rebecca Weber
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Ebru Akdogan
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Vincent Groesser
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Faeq Husain-Syed
- Department of Internal Medicine, Member of the German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Rhein-Main Partner Site, Bad Nauheim, Germany
| | - Pascal Bauer
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany.
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Tso JV, Kim JH. Hypertension in Athletes: Clinical Implications and Management Strategies. Card Electrophysiol Clin 2024; 16:15-24. [PMID: 38280811 DOI: 10.1016/j.ccep.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
Hypertension is a leading cardiovascular risk factor in athletes. Sport-specific behaviors including nonsteroidal anti-inflammatory use, stimulant use, and unhealthy diets may promote hypertension among athletes. Strength-trained athletes may be more susceptible to hypertension than endurance-trained athletes, although this may, in part, be due to body size differences and the more potent antihypertensive effects of aerobic exercise. With confirmed hypertension, young athletes require secondary hypertension evaluation while older athletes require full cardiovascular risk stratification. Calcium channel blockers and renin-angiotensin-system inhibitors are often preferred pharmacotherapy agents. Further selection of antihypertensives must include consideration of potential side effects and legality in specific sports.
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Affiliation(s)
- Jason V Tso
- Division of Cardiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 319, Atlanta, GA 30322, USA. https://twitter.com/jasontsomd
| | - Jonathan H Kim
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, 1462 Clifton Road, Northeast, Suite 502, Atlanta, GA 30322, USA.
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Yuan W, Zhang Y, Chen L, Liu J, Chen M, Guo T, Wang X, Ma T, Ma Q, Jiang J, Cui M, Dong Y, Song Y, Ma J. Lean body mass positively associate with blood pressure in Chinese adults: the roles of ages and body fat distribution. BMC Public Health 2023; 23:2453. [PMID: 38062411 PMCID: PMC10704775 DOI: 10.1186/s12889-023-17312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The relationship between lean body mass (LBM) and blood pressure (BP) is controversial and limited. This study investigated the associations between LBM indexes and BP in adults of different ages and with varying body fat distribution. METHODS The data for the present analysis was obtained from a cross-sectional survey of 1,465 adults (50.7% males) aged 18-70 years conducted in Beijing, China. Regional LBM and fat distribution, including fat mass (FM) and android to gynoid fat ratio (AOI), were assessed using a dual-energy X-ray bone densitometer. Generalized Liner Model (GLM) was employed. Confounders, including age, sex, height, weight, smoking, and alcohol use, were evaluated through questionnaires and physical examinations. RESULTS Males had higher rates of hypertension (11.19% vs. 4.92%) and prehypertension (21.57% vs. 14.59%) than females. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 122.04 mmHg and 76.68 mmHg. There were no significant associations between LBM and DBP (p > 0.05). However, arms LBM (β = 1.86, 95% CI: 0.77, 2.94) and trunk LBM (β = 0.37, 95% CI: 0.01, 0.73) were significantly associated with SBP. The association of LBM on DBP was stronger with increasing ages, and stronger in females than in males (p < 0.001). The association between adults' arms LBM and SBP was stronger in the high level FM group (β = 2.74 vs. β = 1.30) and high level AOI group (β = 1.80 vs. β = 2.08). CONCLUSION The influence of LBM on SBP increases with age, particularly after the age twenty years in females. For adults with high FM or high AOI, LBM in the arms, showed a stronger positive predictive association with SBP. This suggests that, in addition to controlling fat content, future efforts to improve cardiovascular health in adults should include the management of LBM (especially in the upper body).
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Affiliation(s)
- Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Xinxin Wang
- School of Public Health and Management, Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, 750004, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Jianuo Jiang
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Mengjie Cui
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
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Climstein M, Walsh J, DeBeliso M, Heazlewood T, Sevene T, Del Vecchio L, Adams K. Resting Blood Pressure in Master Athletes: Immune from Hypertension? Sports (Basel) 2023; 11:sports11040085. [PMID: 37104159 PMCID: PMC10144796 DOI: 10.3390/sports11040085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
Ageing is associated with decreased physical activity, obesity and increased risk of hypertension (HTN). Master athletes (MA) have either pursued a physically active lifestyle throughout their life or initiated exercise or sport later in life. We assessed resting blood pressure (BP) in male and female World Masters Games (WMG) athletes. This was a cross-sectional, observational study which utilized an online survey to assess the blood pressure (BP) and other physiological parameters. Results: a total of 2793 participants were involved in this study. Key findings included differences between genders with males reporting higher resting SBP (+9.4%, p < 0.001), resting DBP (+5.9%, p < 0.001) and mean arterial pressure (+6.2%, p < 0.001). Significant differences (p < 0.001) were also identified when comparing WMG athletes' resting BP results (genders combined) to the general Australian population with WMG athletes having a lower SBP (p < 0.001, -8.4%) and DBP (p < 0.001, -3.6%). Additionally, 19.9% of males and 49.7% of female WMG participants were normotensive whereas 35.7% of the general Australian population were normotensive. Only 8.1% of the WMG athletes (genders combined) were found to be HTN compared to 17.2% in the general Australian population. These findings reflect a low prevalence of HTN in WMG participants and support our hypothesis of a low prevalence of HTN in an active, but aged cohort of MA.
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Affiliation(s)
- Mike Climstein
- Physical Activity, Sport and Exercise Research (PASER) Theme, Faculty of Health, Southern Cross University, Bilinga, QLD 4225, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing, Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Joe Walsh
- Sport Science Institute, Sydney, NSW 2000, Australia
| | - Mark DeBeliso
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, UT 84720, USA
| | | | - Trish Sevene
- Kinesiology Department, California State University Monterey Bay, Seaside, CA 93955, USA
| | - Luke Del Vecchio
- Faculty of Health Sciences, Southern Cross University, Bilinga, QLD 4225, Australia
| | - Kent Adams
- Kinesiology Department, California State University Monterey Bay, Seaside, CA 93955, USA
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Oleksandr Romanchuk, Oksana Guzii, Anatolii Mahlovanyi, Stepan Sereda, Marian Ostrovskyy. Comparative features of the morphometric correlates of blood pressure response to physical load of qualified athletes in some sports. PHYSICAL REHABILITATION AND RECREATIONAL HEALTH TECHNOLOGIES 2023; 8:3-12. [DOI: https:/doi.org/10.15391/prrht.2023-8(1).01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Purpose: the purpose of this study was to establish morphometric parameters that correlate with the reactivity and recovery of blood pressure in response to a standard physical load in athletes of various game sports.
Material & Methods: to achieve the set goal, 101 qualified male athletes engaged in game sports were examined. All examined represented 3 game sports: 13 – water polo (average age 27.3±6.3 years), 59 – volleyball (average age 21.1±2.5 years), 29 – handball (average age 20.9±2.8 years). The morphometric study was carried out by traditional methods and included the determination of body length (BL, cm), body weight (BW, kg), chest circumference (CC, cm) with calculation of chest excursion (CE, cm), hand dynamometry, vital lung capacity (VLC, ml). Body mass index (BMI, kg×m–2), vital index (VI, ml×kg–1) and Erismann index (IE, c.u.) were calculated separately. The Martine test (20 squats in 30 seconds) was performed according to the traditional method.
Results: changes in SBP in response to load were the significantly greater in handball players compared to water polo players (p=0.025) and compared to volleyball players (p=0.022). Changes in SBP during 3 minutes of recovery are not related to morphometric parameters and obey the general mechanisms of changes in hemodynamic support under the influence of physical load. Changes in DBP during 3 minutes of recovery are related to chest circumference (CC, cm) and proportionality of its development (IE, c.u.) in volleyball and water polo players, and with BW (kg) in handball players. Changes in PBP during 3 minutes of recovery in handball players are not differentiated, in volleyball players they are related to the proportionality of chest development (IE, c.u.), and in water polo players to the BW (kg), CC (cm), mobility and proportionality of chest development (CE, cm and IE, c.u.).
Conclusions: the obtained results confirm that changes in DBP and PBP in response to physical load and during the recovery period after it are related to the morphometric parameters of the body, which can characterize the mechanisms of hemodynamic maintenance recovery and be useful in the selection and the organization of recovery measures in certain sports sport.
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8
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Tso JV, Kim JH. Hypertension in Athletes. Cardiol Clin 2022; 41:15-24. [DOI: 10.1016/j.ccl.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Małek ŁA, Jankowska A, Greszata L. Mild Left Ventricular Hypertrophy in Middle-Age Male Athletes as a Sign of Masked Arterial Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10038. [PMID: 36011673 PMCID: PMC9407928 DOI: 10.3390/ijerph191610038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Mild left ventricular hypertrophy (LVH) has been considered as one of the possible structural, physiological adaptations to regular, intensive physical activity. However, it may also appear as one of the subclinical complications of hypertension. In athletes, the differential diagnosis between these two entities may be complicated as regular physical activity may potentially mask the presence of arterial hypertension. We sought to determine the relation between LVH in middle-age athletes and the presence of hypertension. The study included 71 healthy, male long-time amateur athletes (mean age 41 ± 6 years, 83% endurance and 17% power sports) without known hypertension or any other cardiovascular diseases and with normal self-measured and office blood pressure. All subjects underwent resting electrocardiogram, transthoracic echocardiography, maximal exercise test on a treadmill and ambulatory blood pressure monitoring. LVH was diagnosed as left ventricular wall diameter >11 mm. Hypertension was defined as mean 24 h systolic blood pressure (SBP) ≥ 130 mmHg and/or diastolic blood pressure (DBP) ≥ 80 mmHg. Exaggerated blood pressure response (EBPR) to exercise was defined as SBP ≥ 210 mmHg. LVH (range > 11 to 14 mm) was found in 20 subjects (28%) and hypertension was diagnosed in 33 subjects (46%). Athletes with LVH were more likely to have hypertension than those without LVH (70% vs. 37%, p = 0.01). EBPR to exercise was found equally common in athletes with and without LVH (35% vs. 29%, p = 0.68), but more often in subjects with hypertension (51% vs. 13%, p < 0.001). Presence of LVH and hypertension was equally common in the studied endurance and power sport athletes (p = 0.66 and p = 0.79, respectively). In comparison to athletes without LVH, those with LVH had larger left atrial size (26 ± 6 vs. 21 ± 4 cm2, p < 0.001) and a tendency for lower left ventricular diastolic function (E/A 1.2 ± 0.4 vs. 1.5 ± 0.4, p = 0.05) and a larger ascending aorta diameter (34 ± 3 vs. 32 ± 3, p = 0.05), but a similar left ventricular end-diastolic diameter (51 ± 3 vs. 51 ± 4, p = 0.71). The presence of mild left ventricular hypertrophy in middle-age male amateur athletes with normal home and office blood pressure may be considered as a potential sign of masked hypertension. It should not be overlooked as an element of a physiological adaptation to exercise and may warrant further medical evaluation with ambulatory blood pressure monitoring.
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Affiliation(s)
- Łukasz A. Małek
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-628 Warsaw, Poland
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Torres W, Maillane-Vanegas S, Urban JB, Fernandes RA. Impact of sports participation on cardiovascular health markers of children and adolescents: Systematic review and meta-analysis. World J Clin Pediatr 2022; 11:375-384. [PMID: 36052113 PMCID: PMC9331402 DOI: 10.5409/wjcp.v11.i4.375] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/17/2021] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiovascular diseases have a high prevalence in adults and their development begins in the first decades of life. On the other hand, sports participation in childhood and adolescence provides benefits which can delay the onset of these diseases.
AIM To synthesize the available literature on the impact of sports participation on cardiovascular outcomes in children and adolescents.
METHODS This systematic review was conducted on studies of children and adolescents (aged 8-18 years) who regularly practiced a sport and had reported cardiovascular outcomes (blood pressure and intima-media thickness) recorded. The Medline/PubMed, SciELO, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Bireme databases were searched.
RESULTS In total, 3314 publications for blood pressure and 122 publications for intima-media thickness were identified in the databases. After exclusions (e.g., duplicate articles, animal studies and those that did not meet the inclusion criteria), four publications for blood pressure (449 adolescents) and two publications for intima-media thickness were included (402 adolescents). For blood pressure, all publications were longitudinal in design (follow-up ranging from 12 wk to 12 mo) and involved adolescents aged from 8 years to 18 years of age. For intima-media thickness, both publications were longitudinal in design and involved adolescents aged from 11 years to 18 years of age.
CONCLUSION Sports participation seems to promote benefits to cardiovascular structure and function in adolescents. However, studies with adolescents are scarce and further research is needed to understand this phenomenon.
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Affiliation(s)
- Wesley Torres
- Department of Physical Education, Sao Paulo State University-UNESP, Presidente Prudente 19060900, Sao Paulo, Brazil
| | - Santiago Maillane-Vanegas
- Department of Physical Education, Sao Paulo State University-UNESP, Presidente Prudente 19060900, Sao Paulo, Brazil
| | - Jacqueline Bexiga Urban
- Department of Physical Education, Sao Paulo State University-UNESP, Presidente Prudente 19060900, Sao Paulo, Brazil
| | - Romulo Araujo Fernandes
- Department of Physical Education, Sao Paulo State University-UNESP, Presidente Prudente 19060900, Sao Paulo, Brazil
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11
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Ghasem W, Abouzeid C, Toresdahl BG, Shah AB. Updated Blood Pressure Guidelines: Implications for Athletes. Curr Hypertens Rep 2022; 24:477-484. [PMID: 35788968 DOI: 10.1007/s11906-022-01210-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To review the prevalence, short- and long-term impact of exercise on blood pressure, and the evaluation and treatment of hypertension in competitive athletes. RECENT FINDINGS Due, in part, to inconsistencies in measurement and the definitions used, the true prevalence of hypertension is unknown as reports range from 0 to 83%. With recent changes in the blood pressure guidelines, the proportion of athletes that meet criteria for elevated blood pressure or stage 1 hypertension has increased dramatically with over one-third of collegiate and professional athletes meeting criteria for hypertension. Data consistently show that American-style football players, particularly linemen, display the highest rates of hypertension. These athletes typically have a larger body mass index, higher body fat percentage, and weight gain in serial follow-up. Many athletes with hypertension have traditional risk factors, and, to date, there is no evidence of a causal relationship between long-term sport participation and increased risk of developing hypertension. Many more athletes now meet criteria for hypertension, given the updated blood pressure guidelines. This should be taken as an opportunity for early intervention, as athletes are not immune to the development of cardiovascular risk factors and disease.
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Affiliation(s)
- Wesley Ghasem
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christiane Abouzeid
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brett G Toresdahl
- Primary Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | - Ankit B Shah
- Sports & Performance Cardiology Program, MedStar Health, 3333 N. Calvert St. Suite 500 JPB, Baltimore, MD, 21218, USA.
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12
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Achmad BF, Alim S, Kusumawati HI, Fitriawan AS, Kurniawan D, Kafil RF. Cardiovascular Disease Risk Profiles in Indonesian Athletes. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Notwithstanding how physical exercise lessens cardiovascular and all-cause mortality, young and active athletes might have cardiovascular risk factors or fundamental cardiovascular diseases (CVDs), putting them at increased risk for sudden cardiac death during times of strenuous exercise.
AIM: The study aimed to assess the cardiovascular risk profile possessed by Indonesian athletes.
METHODS: This research was a quantitative study using a cross-sectional design, involving 234 Indonesian athletes (163 men and 71 women) from three sports, including football, basketball, and swimming. Data were collected between December 2020 to March 2021 using the Jakarta Cardiovascular Risk Score instrument adapted from the Framingham risk score. Descriptive statistics were utilized to dissect data information for frequency distribution, percentage, mean, and standard deviation.
RESULTS: Most of the participants in this study had excessive weekly exercise duration (more than 255 minutes/week) (n=177 athletes, 75.64%). Twenty-one participants (8.97%) had a higher MAP more than normal, and 51 participants (21.79%) had overweight BMI. In addition, 142 participants (60.68%) had a cardiovascular genetic disease from their parents (family history) and most of the participants also were active smokers (n=150, 64.10%). Based on the Jakarta Cardiovascular Risk Score, the Indonesian athletes who participated in this study had a mean cardiovascular risk of -1.5 (SD= 3.088, min-max= (-7) – 6). Most of the participants had low cardiovascular risk (n= 193, 82.48%). However, some participants had moderate and high cardiovascular risk, 32 (13.67%) and 9 (3.85%), respectively.
CONCLUSION: Most of the participants had low cardiovascular risk, however some of the participants had moderate and high cardiovascular risk.
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Ferguson-Stegall L, Shanley BJ, Huch AD, Puterbaugh BJ, Faust L, Phousirith A, Scheel H, Williams A, Webb M, Sloop O, Smet M. Hypertension in Healthy College Students: The Hypertension in Young Adults (HiYA) Study. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Nylander T, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Athletes and Non-Athletes: A 4-year follow-up. Clin Physiol Funct Imaging 2022; 42:200-207. [PMID: 35180329 DOI: 10.1111/cpf.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
A follow-up data on electrocardiogram (ECG) and blood pressure (BP) changes in adolescent athletes are scarce. We compared ECG and BP between adolescent athletes and non-athletes in a 4-year follow-up. A total of 154 youth sports clubs (SC) in Finland and 100 secondary schools for comparison data participated in this observational follow-up study. Those who maintained or adopted SC participation are referred to as "Always athletes" (n=137), those who never participated in SC as "Never athletes" (n=108) and those who dropped out of SC during the follow-up as "Changers" (n=116). The mean age of the participants was 15.5 (0.6) years in all study groups at baseline. Resting ECG including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis and QT interval and BP were measured from all participants at baseline and after follow-up. "Always athletes" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude than "Never athletes" at baseline and at 4-years (P < 0.05). "Changers" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude, systolic BP and pulse pressure than "Never athletes" at baseline (P < 0.05). None of the observed differences at baseline, were visible at 4-years (P > 0.05) except the difference in T-wave axis (P = 0.028). The significant group x time interaction between "Changers" and "Never athletes" was found for QRS amplitude (P = 0.017). Adolescent athletes have several training-induced cardiovascular adaptations, which return towards the levels of non-athletes after cessation of regular training. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Heikki Pentikäinen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, University of Helsinki, Helsinki, Finland.,Department of Sports and Exercise Medicine, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Tiina Nylander
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute Foundation, Oulu, Finland
| | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
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15
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Liu Y, Sun G, Li Y. A prospective cohort study on the association of lean body mass estimated by mid-upper arm muscle circumference with hypertension risk in Chinese residents. J Clin Hypertens (Greenwich) 2022; 24:329-338. [PMID: 35174624 PMCID: PMC8925010 DOI: 10.1111/jch.14412] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/15/2021] [Accepted: 11/25/2021] [Indexed: 02/02/2023]
Abstract
The associations of lean body mass (LBM) with elevated blood pressure (BP) and hypertension were controversial, and the causalities have never been shown. Mid-upper arm muscle circumference (MAMC), an easily obtained anthropometric measurement, could provide an accurate estimate for LBM. Therefore, a prospective cohort study in general Chinese residents aiming to find out the relationship between LBM estimated using MAMC and hypertension risk was performed. Eight thousand one hundred eighty-five eligible participants were included in the baseline analysis, among whom 3442 were subsequently selected into cohort analysis. MAMC was calculated using mid-upper arm circumference (MUAC) and triceps skinfold thickness (TST). Associations of MAMC with BP values and hypertension prevalence were estimated by linear and logistic regression models. Associations with hypertension incidence were estimated by COX regression models, hazard ratio (HR) and 95% confidence interval (CI) were given. Nonlinear relationship between MAMC and hypertension risk was estimated using restricted cubic spline method. Standardized coefficients of MUAC and TST were compared to estimate their strengths of associations with hypertension. Baseline analysis showed that after adjusted for confounders, the increase of systolic BP per standard deviation (SD) of MAMC were 1.97 mmHg (95%CI: 1.46, 2.48) and 1.63 mmHg (95%CI: 1.10, 2.16) respectively in men and women, and the increases of diastolic BP per SD were 1.58 mmHg (95%CI: 1.23, 1.92) and 1.08 mmHg (95%CI: 0.74, 1.42). Additionally, the association of MAMC with the prevalence of hypertension were also found in both men and women (OR = 1.36, 95%CI: 1.26, 1.47 in men; OR = 1.33, 95%CI: 1.22, 1.44 in women). Cohort analysis showed that MAMC increased the risk of hypertension (HR = 1.10, 95%CI: 1.01, 1.19 for men; HR = 1.15, 95%CI: 1.06, 1.26 for women), and a trend of J-shaped relationship was found. Additionally, the stronger associations of MUAC with both BP values and hypertension than that of TST were found in both baseline and cohort analyses. Findings in our study implied that we cannot neglect the capacity of LBM in predicting hypertension risk, and LBM estimates should be recommended in general health surveys or examinations.
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Affiliation(s)
- Yuyan Liu
- Department of Clinical EpidemiologyThe Fourth Affiliated Hospital of China Medical UniversityShenyangLiaoningChina
| | - Guifan Sun
- Research Center of Environmental and Non‐Communicable DiseaseSchool of Public HealthChina Medical UniversityShenyangLiaoningChina
| | - Yongfang Li
- Research Center of Environmental and Non‐Communicable DiseaseSchool of Public HealthChina Medical UniversityShenyangLiaoningChina
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deWeber K, Ota KS, Dye C. Pre-bout hypertension in the combat sports athlete: clearance recommendations. PHYSICIAN SPORTSMED 2022; 51:210-216. [PMID: 35019808 DOI: 10.1080/00913847.2022.2025468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hypertension is one of the most prevalent medical disorders in the world and is associated with significant cerebrovascular and cardiovascular morbidity. Pre-bout blood pressure (BP) elevation is extremely common, and ringside physicians must accurately assess the accompanying risk of adverse cerebrovascular and cardiovascular events in the decision to allow participation in combat sports. It is strongly recommended that a ringside physician consider disqualifying a combat sports athlete with severe pre-bout hypertension (systolic BP ≥160 mm Hg and/or diastolic BP ≥100 mm Hg, or stage 2 hypertension in children when indexed by gender, age, and height) from that bout, if it persists despite rest and repeated measurement with accurate equipment. This recommendation is congruent with that of the American College of Sports Medicine, the American College of Cardiology, and the American Heart Association, which recommend non-clearance for sports or exercise testing when BP exceeds those thresholds. Severely elevated BP, as defined above, confers markedly increased risk of morbidity and mortality. Exercise further raises BP markedly. The combination of severely elevated blood pressure and cranial trauma during combat sports is a risk factor for intracranial hemorrhage with a direct impact on the morbidity and mortality associated with ringside combat sports events. Combat sports athletes with SBP ≥130 or DBP ≥90 - and their coaches and families, if available and the athlete consents - should be educated on the causes of hypertension, its acute and chronic risks, and the possible future implications for bout clearance, and the athletes should be referred for evaluation and management.
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Affiliation(s)
- Kevin deWeber
- SW Washington Sports Medicine Fellowship and Family Medicine Residency, Vancouver, WA, USA.,Department of Family Medicine, University of Washington, Seattle, WA, USA.,Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Ken S Ota
- O Longevity and Wellness, Scottsdale, AZ, USA
| | - Cicely Dye
- Department of Cardiology, Jacksonville Naval Hospital, Jacksonville, FL, USA
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17
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Wuestenfeld JC, Baersch F, Ruedrich P, Paech C, Wolfarth B. Blood pressure response to dynamic exercise testing in adolescent elite athletes, what is normal? Front Pediatr 2022; 10:974926. [PMID: 36340728 PMCID: PMC9635448 DOI: 10.3389/fped.2022.974926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In general, only few studies are dedicated to blood pressure behavior under physical stress in children and adolescents. Even less is published about the blood pressure behavior of young high-performance athletes on the ergometer. For this reason, we evaluated the blood pressure behavior under stress compared to non-athletes in a large collective (n = 739) of young high-performance athletes (age 10-20 years, mean 15.8 years, male 442, female 297) of different sports. A complete echocardiographic examination was available in all athletes. RESULT Regardless of gender, the young competitive athletes achieved significantly higher maximum blood pressure values than investastigated populations from previous studies. Based on the data obtained, blood pressure percentiles are now defined explicitly for junior athletes across sports as well as age- and gender-dependent, which did not exist in this form of normal values for the special clientele of young competitive athletes. The echocardiographic examinations demonstrated stress-induced cardiac adaptation adaptations in the majority of athletes, which thus correlate with the comparatively higher stress blood pressures compared to non-athletes. CONCLUSION For the first time, blood pressure percentiles for exercise tests on the ergometer for age groups and gender in high performance athletes are defined based on a comparatively large collective of young competitive athletes. Upper limits were determined, in particular for systolic blood pressure under stress, and categorized according to gender and age. Performance diagnosticians and physicians are now enabled to make a more accurate assessment of the corresponding blood pressure regulation of young athletes under exercise conditions.
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Affiliation(s)
- J C Wuestenfeld
- Department Sports Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Berlin, Germany.,Institute for Applied Training Science (IAT), Department of Sports Medicine, Leipzig, Germany
| | - F Baersch
- Faculty of Sports Science, Institut of Sports Medicine, University Leipzig, Leipzig, Germany
| | - P Ruedrich
- Institute for Applied Training Science (IAT), Department of Sports Medicine, Leipzig, Germany
| | - C Paech
- Department for Pediatric Cardiology, University of Leipzig -Heart Center Leipzig, Leipzig, Germany
| | - B Wolfarth
- Department Sports Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Berlin, Germany.,Institute for Applied Training Science (IAT), Department of Sports Medicine, Leipzig, Germany
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18
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Prevalence of Elevated Blood Pressure and Risk Factors for Hypertension in College Athletes. Clin J Sport Med 2022; 32:e74-e82. [PMID: 34184859 DOI: 10.1097/jsm.0000000000000876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/23/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the prevalence and risk factors for hypertension (HTN) in college athletes using the new (≥130/80 mm Hg) versus prior (≥140/90 mm Hg) US hypertension guidelines. DESIGN Retrospective cohort study. SETTING Eleven Pacific-12 Conference institutions. PARTICIPANTS Of the 8602 athletes enrolled in the primary study, 4977 (57.9%) met inclusion criteria. Athletes were included in the study if age <30 and blood pressure (BP), baseline demographics (age, weight, height, sex, and race), and primary sport were available. INDEPENDENT VARIABLES Age, sex, race, height, weight, body mass index, and primary sport. MAIN OUTCOME MEASURES Elevated BP of ≥130/80 mm Hg and/or ≥140/90 mm Hg. RESULTS Normal BP (<130/80) was present in 3214 (64.6%) athletes and 1763 (35.4%) had BP ≥ 130/80, including 460 (9.2%) with BP ≥ 140/90. Male athletes had a higher prevalence of BP ≥ 130/80 (46.7% vs 21.5%; P < 0.001) and BP ≥ 140/90 (14.2% vs 3.1%; P < 0.001) compared to female athletes. Independent risk factors from multivariate analyses for BP ≥ 130/80 included: older age (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.00-1.11, P = 0.04), male sex (OR = 1.97, 95% CI 1.65-2.35, P < 0.001), heavier weight (OR = 1.03, 95% CI 1.02-1.03, P < 0.001), and baseball as the primary sport (OR = 1.47, 95% CI 1.14-1.90, P < 0.01). Independent risk factors for BP ≥ 140/90 mm Hg included: male sex (OR = 3.54, 95% CI 2.55-4.97, P < 0.001) and heavier weight (OR = 1.03, 95% CI 1.02-1.04, P < 0.001). CONCLUSIONS In a large, diverse cohort of matriculating college athletes from multiple institutions, over one-third presented with elevated BP ≥ 130/80 mm Hg, which was more common in older male athletes with larger body size and baseball players.
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19
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Li M, Lin J, Liang S, Huang S, Wen Z, Mo Z. Predicted Fat Mass, Lean Body Mass, and Risk of Hypertension: Results from a Chinese Male Cohort Study. Obes Facts 2022; 15:638-647. [PMID: 35584613 PMCID: PMC9669944 DOI: 10.1159/000524653] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/16/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Few studies have deciphered whether lean body mass (LBM) or fat mass (FM) is predominantly responsible for the body mass index (BMI)-hypertension association. This study aimed to assess the associations of predicted LBM and FM with hypertension risk among Chinese male adults. METHODS A prospective cohort study was conducted among 2,812 male participants free of hypertension in the Fangchenggang Area Males Health and Examination Survey in 2009. We performed multivariable Cox models and restricted cubic spline to examine the associations of predicted LBM and FM and BMI with hypertension, and to further explore the mediating roles of lipid and glycemic traits in the relationship between predicted FM and blood pressure. RESULTS Of 1,238 participants included in the cohort study, 306 (24.8%) hypertension cases were identified during a median follow-up of 3.8 years, with an incidence rate of 7.0 per 100 person-years. A positive linear-shaped association was consistently observed between BMI and hypertension (p for trend <0.001). Multivariable-adjusted Cox models including predicted LBM and FM observed a positive association between predicted FM and hypertension. Compared with those in the lowest quartile of predicted FM, men in the highest quartile had a hazard ratio (HR) of 1.83 (95% confidence interval (CI): 1.13-2.97) for hypertension. The HR per standard deviation increase of BMI and predicted FM was 1.11 (95% CI: 1.04-1.19) above 23.1 kg/m2 and 1.05 (95% CI: 1.02-1.15) above 14.6 kg, respectively. However, predicted LBM was not associated with hypertension. In addition, high-density lipoprotein cholesterol (HDL-c) and fasting blood glucose (FBG) mediated the relationship of predicted FM with systolic blood pressure, with a mediation ratio of 37.1% and 8.2%, respectively. Furthermore, total cholesterol (TC) and triglyceride (TG) positively mediated the association of predicted FM with diastolic blood pressure, with a mediation ratio of 9.5% and 9.9%, respectively. CONCLUSION Higher predicted FM might play a central role in the positive linear relationship of the BMI-hypertension association in Chinese male adults, and the link from predicted FM to blood pressure was partially mediated by TC, TG, HDL-c, and FBG.
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Affiliation(s)
- Mingli Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Colleges and Universities, Guangxi Medical University, Nanning, China
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Jiali Lin
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Colleges and Universities, Guangxi Medical University, Nanning, China
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Shuang Liang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Colleges and Universities, Guangxi Medical University, Nanning, China
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Shengzhu Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Colleges and Universities, Guangxi Medical University, Nanning, China
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Zheng Wen
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Colleges and Universities, Guangxi Medical University, Nanning, China
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Zengnan Mo,
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20
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Ogawa M, Sagayama H, Tamai S, Momma R, Hoshi D, Uchizawa A, Ichikawa G, Arisaka O, Watanabe K. Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesity. Phys Act Nutr 2021; 25:36-43. [PMID: 34727687 PMCID: PMC8580583 DOI: 10.20463/pan.2021.0019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity. [Methods] We enrolled 70 male children (age 9–17 years [sumo group, n = 14] and 9–14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels). [Results] The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups. [Conclusion] Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.
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Affiliation(s)
- Miori Ogawa
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.,Department of Pediatrics, Nasu Red Cross Hospital, Tochigi, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sports Sciences, University of Tsukuba, Ibaraki, Japan
| | - Shinsuke Tamai
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Reiko Momma
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Daisuke Hoshi
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Akiko Uchizawa
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Go Ichikawa
- Department of Pediatrics, Nasu Red Cross Hospital, Tochigi, Japan
| | - Osamu Arisaka
- Department of Pediatrics, Nasu Red Cross Hospital, Tochigi, Japan
| | - Koichi Watanabe
- Faculty of Health and Sports Sciences, University of Tsukuba, Ibaraki, Japan
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21
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Abstract
Purpose of Review We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. Recent Findings An estimated quarter of the world’s population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual’s eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual’s risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Summary Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.
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Affiliation(s)
- Victor Schweiger
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christine Attenhofer-Jost
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.,Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
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22
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The association of elevated blood pressure during ischaemic exercise with sport performance in Master athletes with and without morbidity. Eur J Appl Physiol 2021; 122:211-221. [PMID: 34652528 PMCID: PMC8748359 DOI: 10.1007/s00421-021-04828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022]
Abstract
Background An exaggerated exercise blood pressure (BP) is associated with a reduced exercise capacity. However, its connection to physical performance during competition is unknown. Aim To examine BP responses to ischaemic handgrip exercise in Master athletes (MA) with and without underlying morbidities and to assess their association with athletic performance during the World Master Track Cycling Championships 2019. Methods Forty-eight Master cyclists [age 59 ± 13yrs; weekly training volume 10.4 ± 4.1 h/week; handgrip maximum voluntary contraction (MVC) 46.3 ± 11.5 kg] divided into 2 matched groups (24 healthy MA and 24 MA with morbidity) and 10 healthy middle-aged non-athlete controls (age 48.3 ± 8.3 years; MVC 40.4 ± 14.8 kg) performed 5 min of forearm occlusion including 1 min handgrip isometric contraction (40%MVC) followed by 5 min recovery. Continuous beat-by-beat BP was recorded using finger plethysmography. Age-graded performance (AGP) was calculated to compare race performances among MA. Healthy Master cyclists were further grouped into middle-age (age 46.2 ± 6.4 years; N:12) and old-age (age 65.0 ± 7.7 years; N:12) for comparison with middle-aged non-athlete controls. Results Healthy and morbidity MA groups showed similar BP responses during forearm occlusion and AGP (90.1 ± 4.3% and 91.0 ± 5.3%, p > 0.05, respectively). Healthy and morbidity MA showed modest correlation between the BP rising slope for 40%MVC ischaemic exercise and AGP (r = 0.5, p < 0.05). MA showed accelerated SBP recovery after cessation of ischaemic handgrip exercise compared to healthy non-athlete controls. Conclusion Our findings associate long-term athletic training with improved BP recovery following ischaemic exercise regardless of age or reported morbidity. Exaggerated BP in Master cyclists during ischaemic exercise was associated with lower AGP during the World Master Cycling Championships. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-021-04828-9.
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23
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Pavlik G, Kováts T, Kneffel Z, Komka Z, Radák Z, Tóth M, Nemcsik J. Characteristics of the athlete's heart in aged hypertensive and normotensive subjects. J Sports Med Phys Fitness 2021; 62:990-996. [PMID: 34546024 DOI: 10.23736/s0022-4707.21.12699-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Both hypertension and age-related impairment of the cardiac condition are known to be improved by regular physical training. As relatively few studies have been reported about the older, hypertensive patients, the aim of this study was to establish cardiac benefits of active lifestyle in these subjects. METHODS Two-dimensionally guided M-mode, Doppler- and tissue Doppler echocardiography was performed in 199 normo- and hypertensive, active and sedentary older (age>60 yrs.) men (111) and women (88). Results were compared either by ANOVA, or by Kruskall-Wallis test. RESULTS The left ventricular muscle index (LVMI), which is higher in young active than in sedentary persons, proved to be smaller in the active than sedentary older subjects: men normotensives: actives 83 vs. sedentary ones 98, hypertensives: actives 88 vs. sedentary ones 107, women normotensives: actives 77 vs. sedentary ones 89 g/m3. Diastolic function was better in the active groups demonstrated both by the ratio of the early to atrial peak blood flow velocities (men: normotensives: actives 1.03 vs. sedentary ones 0.76, women normotensives: actives 1.21 vs. sedentary ones 0.9, hypertensives: actives 1.04 vs. sedentary ones 0.88). The tissue Doppler results were also better in the active groups; the difference between the active and sedentary groups was more marked in the normotensive male groups than in the hypertensive ones. CONCLUSIONS Active lifestyle prevents age-related pathological LV hypertrophy, and attenuates the LV diastolic dysfunction.
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Affiliation(s)
- Gábor Pavlik
- Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary -
| | - Tímea Kováts
- Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary.,The Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Kneffel
- Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary
| | - Zsolt Komka
- Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary.,The Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Zsolt Radák
- Research Centre for Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Mikós Tóth
- Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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24
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Abstract
Given the participation of the microbiome in human health and disease, understanding the context of host-microbe interactions involved in vascular pathophysiology is now evolving through identifying microbial communities, specific taxa, and metabolic profiling which can be coupled to human health outcomes. Exercise has been used to define mechanisms related to improved vascular health, which may involve the microbiome. Motivated by the clinical significance that both exercise and the gut microbiome have; the objective of our work is to assist in defining the gut-vascular axis while identifying biomarkers of gut microbial health linked to vascular function. In this commentary, we will provide context to the mechanistic perspectives of exercise-induced improvements in gut microbial characteristics coupled to vascular health outcomes and offer insight on necessary future prospective investigations.
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25
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Sánchez I, de la Rubia Ortí JE, Platero JL, Mariscal G, Barrios C. Modification of Diurnal Cortisol Secretion in Women's Professional Basketball. A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8961. [PMID: 34501551 PMCID: PMC8430658 DOI: 10.3390/ijerph18178961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/22/2021] [Indexed: 12/02/2022]
Abstract
Elite basketball training causes high levels of physiological stress, which can lead to negative physiological disorders in female athletes. The aim of this study was to establish the impact of physical activity on the rhythm of salivary cortisol secretion in elite female basketball players over one week. The population sample included 9 women professional basketball players. The control group was made up of 9 women who did not do any exercise. Saliva samples were collected from all participants at 9:00 a.m. and 11:00 p.m. on training days. Samples from the basketball group showed a significantly higher cortisol secretion. Moreover, from the second night, the pattern of cortisol secretion of these players was reversed, showing higher levels of cortisol in saliva at night than in the morning. The results suggest that the secretion rhythm changed over the course of the week and according to competitive demands.
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Affiliation(s)
- Irene Sánchez
- Institute for Research on Musculoskeletal Disorders, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (I.S.); (C.B.)
| | - Jose Enrique de la Rubia Ortí
- Department of Nursing, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (J.E.d.l.R.O.); (J.L.P.)
| | - Jose Luis Platero
- Department of Nursing, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (J.E.d.l.R.O.); (J.L.P.)
| | - Gonzalo Mariscal
- Institute for Research on Musculoskeletal Disorders, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (I.S.); (C.B.)
| | - Carlos Barrios
- Institute for Research on Musculoskeletal Disorders, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (I.S.); (C.B.)
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26
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Yu Y, Chang C, Wu Y, Guo C, Xie L. Dose-effect relationship between brisk walking and blood pressure in Chinese occupational population with sedentary lifestyles: Exercise and blood pressure. J Clin Hypertens (Greenwich) 2021; 23:1734-1743. [PMID: 34390121 PMCID: PMC8678794 DOI: 10.1111/jch.14340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 01/10/2023]
Abstract
The purpose of this study was to explore the effects of brisk walking on blood pressure (BP) in Chinese Han occupational populations to identify the appropriate volume of exercise needed for BP management. Eight-hundred and two office staff with sedentary lifestyles were recruited to receive a prescription pedometer-assisted brisk walking intervention for 3 months. To evaluate exercise intervention efficiency using statistical methods, the effective steps was divided as follows: 4000- < 8000 (Level 1), 8000- < 10 000 (Level 2), 10 000-12 000 (Level 3), and > 12 000 (Level 4) steps/day. The data of 688 participants who completed the study were analyzed. After intervention, Systolic BP (SBP) and Diastolic BP (DBP) at Levels 1-3 were significantly decreased (p < .05). For participants with hypertension at baseline, all four levels demonstrated a significantly reduced SBP and DBP. In addition, there was a significant dose-effect relationship between the effective steps and the SBP. Compared with the maximum effective steps level (Level 4), the average change of SBP between level 1-3 and level 4 were statistically significant, with -3.24 mm Hg (95%CI: -5.74 to -0.74, p = .011), -2.58 mm Hg (95%CI: -4.73 to -0.43, p = .019), and -2.19 mm Hg (95%CI: -4.20 to -0.18, p = .033), respectively. For the hypertensive cohort, only the difference between Level 1 and 4 was statistically significant (Level 1 vs. Level 4: difference in means = -6.22 mm Hg, 95%CI: -12.68 to -0.24, p = .036). No significant dose-effect relationship of DBP was observed. Our findings showed brisk walking can effectively control BP in Chinese populations and a significant dose-effect relationship was found between exercise and SBP.
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Affiliation(s)
- Yingxiang Yu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Cuiqing Chang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Yifan Wu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Chengcheng Guo
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Lan Xie
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
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27
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Lentini M, Scalia J, Lebel FB, Touma F, Jhajj A, Darlington PJ, Dover G. Association Between Pain Catastrophizing and Pain and Cardiovascular Changes During a Cold-Pressor Test in Athletes. J Athl Train 2021; 56:473-483. [PMID: 34000018 DOI: 10.4085/1062-6050-016-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Athletes are often exposed to pain due to injury and competition. Using preliminary evidence, researchers have shown that cardiovascular measures could be an objective measure of pain, but the cardiovascular response can be influenced by psychological factors, such as catastrophizing. OBJECTIVE To use a painful cold-pressor test (CPT) to measure the relationship among catastrophizing, pain, and cardiovascular variables in athletes. DESIGN Cohort study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 male rugby athletes (age = 24.0 ± 4.6 years, height = 180.0 ± 6.1 cm, mass = 90.5 ± 13.8 kg). MAIN OUTCOME MEASURE(S) We measured catastrophizing using the Pain Catastrophizing Scale and pain using a numeric pain rating scale. Cardiovascular measures were heart rate, systolic and diastolic blood pressure, and heart rate variability. RESULTS During the CPT, participants experienced increases in pain (from 0 to 4.1 ± 2.2), systolic blood pressure (from 126.7 ± 16.5 to 149.7 ± 23.4 mm Hg), diastolic blood pressure (from 76.9 ± 8.3 to 91.9 ± 11.5 mm Hg), and heart rate variability (from 0.0164 ± 0.0121 to 0.0400 ± 0.0323 milliseconds; all P values < .001). In addition, we observed a decrease in heart rate after the CPT (P = .04). We found a correlation between athletes' pain catastrophizing and both pain intensity and change in heart rate during the CPT (P = .02 and P = .003, respectively). Linear regression indicated that pain and catastrophizing explained 29% of the variance in the change in heart rate (P = .003). CONCLUSIONS Athletes who had catastrophizing thoughts were more likely to experience higher levels of pain and a greater cardiovascular response during a painful stimulus. The change in cardiovascular variables may be a good objective measure of pain in athletes in the future.
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Affiliation(s)
- Matylda Lentini
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Joseph Scalia
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Frédérike Berger Lebel
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Fadi Touma
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Aneet Jhajj
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Peter J Darlington
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada
| | - Geoffrey Dover
- PERFORM Centre, Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QE, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Constance Lethbridge Centre, CIUSSS du Centre-Ouest-de-l'Île-de Montréal, QE, Canada
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28
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes. J Athl Train 2021; 56:484-490. [PMID: 33150370 DOI: 10.4085/78-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. OBJECTIVE To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. DESIGN Cross-sectional study. SETTING A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. PATIENTS OR OTHER PARTICIPANTS We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools. MAIN OUTCOME MEASURE(S) Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. RESULTS No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). CONCLUSIONS Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.
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Affiliation(s)
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Center & Unit of Health and Physical Activity University of Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Finland.,Center for Life Course Health Research, University of Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Finland
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Brachial and central blood pressure and arterial stiffness in adult elite athletes. Eur J Appl Physiol 2021; 121:1889-1898. [PMID: 33713201 PMCID: PMC8192367 DOI: 10.1007/s00421-021-04662-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/02/2021] [Indexed: 11/24/2022]
Abstract
Purpose Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of cardiovascular events. The effects of physical training are widely unexplored in the context of competitive, high-performance sports. Therefore, we aimed to present possible reference values of brachial and central BP and of AS of adult elite athletes compared to a control group. Methods A total of 189 subjects participated in this cross-sectional study. Of these were 139 adult elite athletes (70 male, 69 female) performing on top-national and international level, and 50 control subjects (26 male, 24 female). Resting brachial and central BP and aortic pulse wave velocity (PWV) were measured and were compared in terms of sex, sport category, and age of the athletes. Results Results show no difference between athletes and controls in any parameter. Women exhibit lower brachial and central BP and AS values compared to men. PWV is positively correlated with age. Evaluation of the parameters according to the different sport categories showed that endurance athletes exhibit lower BP and PWV compared to other athletes. Conclusions This study presents brachial and central BP and PWV values of athletes, suggesting that high-performance sport does not negatively impact AS. The proposed reference values might support a more detailed evaluation of elite athlete’s cardiovascular and hemodynamic system and a better assignment to possible risk groups.
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30
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Castelletti S, Gati S. The Female Athlete's Heart: Overview and Management of Cardiovascular Diseases. Eur Cardiol 2021; 16:e47. [PMID: 34950243 PMCID: PMC8674625 DOI: 10.15420/ecr.2021.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/15/2021] [Indexed: 12/12/2022] Open
Abstract
The number of female athletes taking part in elite and amateur sport is ever increasing. In contrast with male athletes, few studies have focused on cardiovascular adaptations to exercise in women, the effects of lifelong exercise on heart muscle and electrical tissue, the risk of exerciserelated sudden cardiac death and the management of cardiovascular disease. Women have a lower prevalence of large QRS complexes, repolarisation changes including inferior and lateral T-wave inversion, and cardiac dimensions exceeding predicted limits compared with men. The risk of exercise-related sudden cardiac death is significantly lower in women than men. Also, women who have engaged in lifelong exercise do not have a higher prevalence of AF, coronary artery calcification or myocardial fibrosis than their sedentary counterparts. Apart from providing an overview of the existing literature relating to cardiac adaptations, this review explores possible reasons for the sex differences and focuses on the management of cardiovascular disorders that affect female athletes.
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Affiliation(s)
- Silvia Castelletti
- Cardiomyopathy Unit and Center for Cardiac Arrhythmias of Genetic Origin, Department of Cardiovascular, Neural and Metabolic Science, Istituto Auxologico Italiano IRCCSMilan, Italy
| | - Sabiha Gati
- National Heart and Lung Institute, Imperial College LondonUK
- Department of Cardiology, Royal Brompton HospitalLondon, UK
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31
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Richard NA, Hodges L, Koehle MS. Elevated peak systolic blood pressure in endurance-trained athletes: Physiology or pathology? Scand J Med Sci Sports 2021; 31:956-966. [PMID: 33382462 DOI: 10.1111/sms.13914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/17/2020] [Accepted: 12/27/2020] [Indexed: 01/21/2023]
Abstract
Blood pressure is a function of cardiac output and peripheral vascular resistance. During graded exercise testing (GXT), systolic blood pressure (SBP) is expected to increase gradually along with work rate, oxygen consumption, heart rate, and cardiac output. Individuals exposed to chronic endurance training attain a greater exercise SBP than in their untrained state and sedentary counterparts, but it is currently unknown what is considered a safe upper limit. This review discusses key studies examining blood pressure response in sedentary individuals and athletes. We highlight the physiological characteristics of highly fit individuals in terms of cardiovascular physiology and exercise blood pressure and review the state of the current literature regarding the safety of high SBP during exercise in this particular subgroup. Findings from this review indicate that a consensus on what is a normal SBP response to exercise in highly fit subjects and direct causation linking high GXT SBP to pathology is lacking. Consequently, applying GXT SBP guidelines developed for a "normal" population to endurance-trained individuals appears unsupported at this time. Lack of evidence for poor outcomes leads us to infer that elevated peak SBP in this subgroup could more likely reflect an adaptive response to training, rather than a pathological outcome. Future studies should track clinical outcomes of those achieving elevated SBP and develop athlete-specific guidelines.
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Affiliation(s)
| | - Lynette Hodges
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Michael S Koehle
- School of Kinesiology, University of British Columbia, Vancouver, Canada.,Division of Sports Medicine, University of British Columbia, Vancouver, Canada
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32
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Peinado AB, Alfaro-Magallanes VM, Romero-Parra N, Barba-Moreno L, Rael B, Maestre-Cascales C, Rojo-Tirado MA, Castro EA, Benito PJ, Ortega-Santos CP, Santiago E, Butragueño J, García-de-Alcaraz A, Rojo JJ, Calderón FJ, García-Bataller A, Cupeiro R. Methodological Approach of the Iron and Muscular Damage: Female Metabolism and Menstrual Cycle during Exercise Project (IronFEMME Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020735. [PMID: 33561085 PMCID: PMC7831010 DOI: 10.3390/ijerph18020735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/21/2022]
Abstract
Abstract Background: The increase in exercise levels in the last few years among professional and recreational female athletes has led to an increased scientific interest about sports health and performance in the female athlete population. The purpose of the IronFEMME Study described in this protocol article is to determine the influence of different hormonal profiles on iron metabolism in response to endurance exercise, and the main markers of muscle damage in response to resistance exercise; both in eumenorrheic, oral contraceptive (OC) users and postmenopausal well-trained women. Methods: This project is an observational controlled randomized counterbalanced study. One hundered and four (104) active and healthy women were selected to participate in the IronFEMME Study, 57 of which were eumenorrheic, 31 OC users and 16 postmenopausal. The project consisted of two sections carried out at the same time: iron metabolism (study I) and muscle damage (study II). For the study I, the exercise protocol consisted of an interval running test (eight bouts of 3 min at 85% of the maximal aerobic speed), whereas the study II protocol was an eccentric-based resistance exercise protocol (10 sets of 10 repetitions of plate-loaded barbell parallel back squats at 60% of their one repetition maximum (1RM) with 2 min of recovery between sets). In both studies, eumenorrheic participants were evaluated at three specific moments of the menstrual cycle: early-follicular phase, late-follicular phase and mid-luteal phase; OC users performed the trial at two moments: withdrawal phase and active pill phase. Lastly, postmenopausal women were only tested once, since their hormonal status does not fluctuate. The three-step method was used to verify the menstrual cycle phase: calendar counting, blood test confirmation, and urine-based ovulation kits. Blood samples were obtained to measure sex hormones, iron metabolism parameters, and muscle damage related markers. Discussion: IronFEMME Study has been designed to increase the knowledge regarding the influence of sex hormones on some aspects of the exercise-related female physiology. Iron metabolism and exercise-induced muscle damage will be studied considering the different reproductive status present throughout well-trained females’ lifespan. Trial registration The study was registered at Clinicaltrials.gov NCT04458662 on 2 July 2020.
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Affiliation(s)
- Ana B. Peinado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - Victor M. Alfaro-Magallanes
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Beatriz Rael
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Cristina Maestre-Cascales
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel A. Rojo-Tirado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Eliane A. Castro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, 2850 Concepción, Chile
| | - Pedro J. Benito
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | | | - Javier Butragueño
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
| | - Antonio García-de-Alcaraz
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Faculty of Educational Sciences, Universidad de Almería, 04120 Almería, Spain
| | - Jesús J. Rojo
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Francisco J. Calderón
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Alberto García-Bataller
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Rocío Cupeiro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Arena SK, Jones S, Munoz AM, Murley M, Strudwick Melton C, Sakyi K, Hew-Butler T. Resting Blood Pressure in Collegiate Swimmers During a Competitive Season: A Prospective Observational Study. Cureus 2020; 12:e12340. [PMID: 33520536 PMCID: PMC7837667 DOI: 10.7759/cureus.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction The purpose of this study was to describe and examine differences in resting blood pressure (BP) during an eight-week time frame in the course of the competitive season among collegiate swimmers of varied sexes. Methods A prospective observational study using a sample of convenience of National Collegiate Athletic Association (NCAA) Division 1 female and male swimmers from one university were invited to participate. Blood pressure was measured using standardized methodology at six encounters spaced over eight weeks. Descriptive statistics analyzed demographics, mean BP, and BP classifications. A pairwise t-test analyzed differences in the mean BP and BP classification by sex. The Bonferroni correction was applied given the multiple variables included in the analysis with statistical significance determined to be p≤0.002. Results Thirty-eight swimmers (15 males and 23 females) met the inclusion criteria. Differences between sexes were identified with a higher mean diastolic BP observed in males at the third encounter (p=0.0004) and a higher mean systolic BP observed in males at the sixth encounter (p=0.0002). Four males and four females were identified with a BP classified as stage 1 or 2 hypertension at the first encounter; however, six males and no females met this criterion at the last encounter which was statistically significant (p=0.0004). Conclusions Increased BP from baseline measured for systole, diastole, and BP classifications was significant in male compared to female swimmers. Specifically, divergence in BP by sex first appeared in the diastolic measures at three weeks and in the systolic measures and BP classifications by eight weeks.
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Affiliation(s)
- Sara K Arena
- Physical Therapy, Oakland University, Rochester, USA
| | - Scott Jones
- Physical Therapy, Oakland University, Rochester, USA
| | | | - Meghan Murley
- Physical Therapy, Oakland University, Rochester, USA
| | | | - Kwame Sakyi
- Public and Environmental Wellness, Oakland University, Rochester, USA
| | - Tamara Hew-Butler
- Exercise and Sport Science, College of Education, Wayne State University, Detroit, USA
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Mohammed LLM, Dhavale M, Abdelaal MK, Alam ABMN, Blazin T, Prajapati D, Mostafa JA. Exercise-Induced Hypertension in Healthy Individuals and Athletes: Is it an Alarming Sign? Cureus 2020; 12:e11988. [PMID: 33437543 PMCID: PMC7793423 DOI: 10.7759/cureus.11988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Exercise-induced hypertension (EIH) is defined as elevated blood pressure (BP) > 190mm Hg for females and > 210 mmHg for males during exercise. EIH is prevalent among athletes and healthy individuals with no cardiovascular (CV) risk factors. While previous data corroborates exercise in reducing hypertension and cardiovascular risk, the development of EIH and its attendant cardiovascular risk necessitates a review of the pathophysiological mechanisms resulting in EIH. To date, these mechanisms causing EIH are not fully understood, nor are there any established guidelines on the management of EIH. In this article, we discuss in detail the pathophysiological mechanisms, the prognostic value, clinical implications, possible treatment, and future directions in managing EIH.
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Affiliation(s)
- Linha Lina M Mohammed
- Miscellaneous, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meera Dhavale
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed K Abdelaal
- Surgery/General and Visceral Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - A B M Nasibul Alam
- Miscellaneous, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tatjana Blazin
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dhruvil Prajapati
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry/Psychotherapy, California Institute of Behavorial Neurosciences & Psychology, Fairfield, USA
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Hackett DA, Mitchell L, Clarke JL, Hagstrom AD, Keogh J, McLellan C. Relationship between echocardiogram and physical parameters in experienced resistance trainers: a pilot study. J Sports Med Phys Fitness 2020; 61:1290-1300. [PMID: 33269882 DOI: 10.23736/s0022-4707.20.11615-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A paucity of research exists concerning physiological factors influencing heart structure and function in strength athletes. This pilot study investigated whether body composition and muscle performance are associated with indices of cardiac structure and function in experienced resistance trainers. METHODS A cross-sectional study designed was employed to address the study aim. Seventeen males (median age 33.0 years) and eight females (median age 32.5 years) with backgrounds in bodybuilding and powerlifting participated in this study. Muscle performance, body composition and echocardiographic measures were performed. Mann-Whitney U-tests were used to examine differences between males and females. Spearman's Rho partial correlation analyses (adjusting for sex) were conducted to examine relationships between physical and echocardiogram parameters. RESULTS Moderate to strong positive correlations were found between fat-free mass and aortic root, right ventricular internal dimension, interventricular septum thickness, left ventricular posterior wall thickness, left atrium area, left ventricular end-diastolic volume, and left ventricular end-systolic volume (r: 0.43-0.76, P≤0.03). Moderate to strong positive correlations were found between leg press 1RM and aortic root, left ventricular internal dimension diastole, left atrium area, left ventricular end-diastolic volume, and left ventricular end-systolic volume (r: 0.49-0.67, P≤0.02). CONCLUSIONS Resistance trainers with greater fat-free mass and lower body strength appear to have larger cardiac structures. Changes in heart size and function are likely to result from long-term strenuous resistance training. Due to the suspected prevalence of performance enhancing drug use among powerlifters and bodybuilders, care is required to rule out pathological conditions.
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Affiliation(s)
- Daniel A Hackett
- Exercise, Health and Performance Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, Australia -
| | - Lachlan Mitchell
- National Nutrition Surveillance Center, School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Jillian L Clarke
- Exercise, Health and Performance Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, Australia
| | - Amanda D Hagstrom
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia.,Sports Performance Research Center New Zealand, AUT University, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chris McLellan
- School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Ipswich, Australia
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Larsen B, Bellettiere J, Allison M, McClelland RL, Miljkovic I, Vella CA, Ouyang P, De-Guzman KR, Criqui M, Unkart J. Muscle area and density and risk of all-cause mortality: The Multi-Ethnic Study of Atherosclerosis. Metabolism 2020; 111:154321. [PMID: 32712219 PMCID: PMC8062068 DOI: 10.1016/j.metabol.2020.154321] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/29/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lean muscle plays critical roles in physical functioning and metabolism. However, little is known regarding associations between muscle and mortality in adults. OBJECTIVE The purpose was to evaluate associations between abdominal muscle quantity (area) and quality (density) with risk of all-cause mortality in a diverse cohort free of cardiovascular disease. DESIGN Data were taken from the Abdominal Body Composition, Inflammation, and Cardiovascular Disease ancillary study of the Multi-Ethnic Study of Atherosclerosis prospective cohort study. Participants were adults (45-85 years) free of extant cardiovascular disease, and of Hispanic, African American, Chinese, or Caucasian descent. Of the original 6814 MESA participants, a random, representative sample (n = 1974) participated in the ancillary body composition study. Abdominal muscle area and density were measured from computed tomography scans spanning L2-L4. Muscle density was measured as attenuation in Hounsfield units, and area was quantified as cm2. Gender-stratified cox proportional hazard models assessed the risk of all-cause mortality across gender-specific quartiles of muscle area and density adjusting for confounders, with area and density entered simultaneously. RESULTS At baseline, the mean age for men (n = 946) and women (n = 955) was 61.5 and 62.5 years and median follow-up time was 10.6 and 10.9 years, respectively. Muscle density was inversely associated with mortality, with the highest quartile of density showing a 73% reduction in risk for men (HR = 0.27, 95% CI = 0.14-0.51; p-trend<0.001) and 57% reduction for women (HR = 0.43, 95% CI = 0.18-1.01; p-trend = 0.04) compared to the lowest quartile when adjusting for mortality risk factors, lifestyle, BMI and visceral fat. There was no association between muscle area and all-cause mortality for men (p-trend = 0.58) or women (p-trend = 0.47). CONCLUSIONS Greater abdominal muscle density, but not muscle area, is associated with markedly lower risk of all-cause mortality across a decade of follow up. Muscle quality may be a powerful predictor of mortality in community dwelling adults.
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Affiliation(s)
- Britta Larsen
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America.
| | - John Bellettiere
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburg, Pittsburg, PA, United States of America
| | - Chantal A Vella
- Department of Movement Sciences, University of Idaho, Boise, ID, United States of America
| | - Pamela Ouyang
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Kimberly R De-Guzman
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America
| | - Michael Criqui
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America
| | - Jonathan Unkart
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States of America
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(Hypertension and sports). COR ET VASA 2020. [DOI: 10.33678/cor.2020.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Effect of Training Phase on Physical and Physiological Parameters of Male Powerlifters. Sports (Basel) 2020; 8:sports8080106. [PMID: 32751554 PMCID: PMC7466622 DOI: 10.3390/sports8080106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/19/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Longitudinal research on training and dietary practices of natural powerlifters is limited. This study investigated the effect of phases of training on physical and physiological parameters in male natural powerlifters. Nine participants completed testing at two time points: (i) preparatory phase (~3 months prior to a major competition) and (ii) competition phase (1–2 weeks from a major competition). No significant changes between training phases were found for muscle strength and power. A trend for significance was found for decreased muscle endurance of the lower body (−24.4%, p = 0.08). A significant increase in leg lean mass was found at the competition phase (2.3%, p = 0.04), although no changes for other body composition measures were observed. No change was observed for any health marker except a trend for increased urinary creatinine clearance at the competition phase (12.5%, p = 0.08). A significant reduction in training volume for the lower body (−75.0%, p = 0.04) and a trend for a decrease in total energy intake (−17.0%, p = 0.06) was observed during the competition phase. Despite modifications in training and dietary practices, it appears that muscle performance, body composition, and health status remain relatively stable between training phases in male natural powerlifters.
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Bauer P, Kraushaar L, Dörr O, Bauer T, Nef H, Hamm CW, Most A. Association of 25-hydroxy vitamin D level with the blood pressure response to a maximum exercise test among professional indoor athletes. Eur J Appl Physiol 2020; 120:1931-1941. [PMID: 32588193 PMCID: PMC7340632 DOI: 10.1007/s00421-020-04421-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/13/2020] [Indexed: 12/17/2022]
Abstract
Purpose Low vitamin D levels have been associated with elevated blood pressure (BP) in the general population. However, whether there is an association of vitamin D insufficiency with BP changes during maximum exercise in athletes is currently unclear.
Methods A total of 120 male professional indoor athletes (age 26 ± 5 years) were examined. BP was measured at rest and during a graded cycling test. We assessed the BP response (BPR) during maximum exercise and the respective load. BP and BPR (peak-baseline BP) were analysed with respect to 25-OH vitamin D levels, with levels < 30 ng/mL defining vitamin D insufficiency.
Results 35 athletes were classified as being vitamin D insufficient. BP was not different between sufficient and insufficient vitamin D groups (122 ± 10/75 ± 7 vs. 120 ± 12/77 ± 9 mmHg). At maximum exercise, however, systolic BP (198 ± 17 vs. 189 ± 19, p = 0.026) and the pulse pressure (118 ± 18 vs. 109 ± 21 mmHg, p = 0.021) were higher in the sufficient group; the BPR was not different between groups (76 ± 20/5 ± 6 vs. 69 ± 22/3 ± 6 mmHg, p = 0.103). Athletes with sufficient levels had a higher maximum power output (3.99 ± 0.82 vs. 3.58 ± 0.78 W/kg, p = 0.015) and achieved higher workloads (367 ± 78 vs. 333 ± 80 W, p = 0.003). The workload-adjusted BPR (maximum systolic BP/MPO) was not different between athletes with sufficient and insufficient vitamin D levels (51 ± 10 vs. 56 ± 14 mmHg × kg/W, p = 0.079).
Conclusion Athletes with sufficient vitamin D achieved a higher maximum systolic BP and a higher maximum power output. The workload-adjusted BPR was not different between groups, which suggests that this finding reflects a better performance of athletes with sufficient vitamin D.
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Affiliation(s)
- Pascal Bauer
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany.
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Timm Bauer
- Department of Cardiology and Intensive Care Medicine, Sana Clinic Offenbach, Offenbach, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany.,Department of Cardiology, Kerckhoff Clinic GmbH, Bad Nauheim, Germany
| | - Astrid Most
- Department of Cardiology and Angiology, Justus- Liebig- University Giessen, Giessen, Germany
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Crawford MA, Criqui MH, Forbang N, Unkart JT, Allison MA, Larsen BA. Associations of abdominal muscle area and density with coronary artery calcium volume and density: The multi-ethnic study of atherosclerosis. Metabolism 2020; 107:154230. [PMID: 32298722 PMCID: PMC7986552 DOI: 10.1016/j.metabol.2020.154230] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Due to the opposing cardiovascular risk profiles of CAC volume and density, we tested the hypothesis that increased abdominal muscle area (AMA) and density (AMD) were significantly associated with lower coronary arterial calcium (CAC) volume and higher CAC density. METHODS Using data from 787 participants from the Multi-Ethnic Study of Atherosclerosis, Ancillary Body Composition Study, we analyzed abdominal and chest computed tomography (CT) scans. Abdominal scans were scored for muscle area, muscle density (attenuation) and visceral and subcutaneous fat. Chest scans were scored for CAC volume and Agatston values, which were used to derive CAC density scores. RESULTS The mean (SD) age and BMI of the participants was 67.8 (9.0) years and 27.9 (4.8) kg/m2, respectively. Forty-one percent were female, 46% were Caucasian, 60% had hypertension, 17% had diabetes, and 46% had dyslipidemia. AMA was positively associated with CAC volume (p < .001) and inversely associated with CAC density (p < .001). Conversely, AMD was inversely associated with CAC volume and positively associated with CAC density in minimally adjusted models (p < .001), but not significant in confounder adjusted models. CONCLUSION AMA and AMD had differing associations with CAC volume and density, with AMA significantly associated with a higher risk CAC profile (high volume, low density) and AMD not significantly associated with CAC volume or density. Future research needs to account for the unique components of both muscle composition and CAC.
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Affiliation(s)
- Margaret A Crawford
- University of California, San Diego/San Diego State University Joint Doctoral Program in Public Health, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America
| | - Michael H Criqui
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America
| | - Nketi Forbang
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America
| | - Jonathan T Unkart
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America
| | - Matthew A Allison
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America
| | - Britta A Larsen
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0965, United States of America.
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Bauer P, Kraushaar L, Dörr O, Nef H, Hamm CW, Most A. Workload-indexed blood pressure response to a maximum exercise test among professional indoor athletes. Eur J Prev Cardiol 2020; 28:1487-1494. [PMID: 33611510 DOI: 10.1177/2047487320922043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exercise testing is performed regularly in professional athletes. However, the blood pressure response (BPR) to exercise is rarely investigated in this cohort, and normative upper thresholds are lacking. Recently, a workload-indexed BPR (increase in systolic blood pressure per increase in metabolic equivalent of task (SBP/MET slope)) was evaluated in a general population and was compared with mortality. We sought to evaluate the SBP/MET slope in professional athletes and compare it with performance. DESIGN This was a cross-sectional study. METHODS A total of 142 male professional indoor athletes (age 26 ± 5 years) were examined. Blood pressure was measured at rest and during a standardized, graded cycle ergometer test. We assessed the BPR during exercise, the workload, and the metabolic equivalent of task (MET). Athletes were divided into groups according to their SBP/MET slope quartiles (I <4.3; II 4.3-6.2; III >6.2-9; IV >9 mmHg/MET) and compared regarding systolic BP (sBP) and workload achieved. RESULTS Athletes in group I (n = 42) had the lowest maximum sBP (180 ± 13 mmHg) but achieved the highest relative workload (4.2 ± 1 W/kg). With increasing SBP/MET slope, the maximum sBP increased (II (n = 56): 195 ± 15 mmHg; III (n = 44): 216 ± 16 mmHg) and the workload achieved decreased (II: 3.9 ± 0.7 W/kg; III: 3.3 ± 0.5 W/kg). The differences in sBP between these groups were significant (p < 0.001). None of the athletes were assigned to group IV (>9 mmHg/MET). CONCLUSION Athletes in the lowest SBP/MET slope quartile displayed the lowest maximum sBP but achieved a higher workload than athletes classified into the other SBP/MET slope groups. This simple, novel metric might help to distinguish a normal from an exaggerated BPR to exercise, to identify athletes at risk of developing hypertension.
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Affiliation(s)
- Pascal Bauer
- Department of Cardiology and Angiology, University Hospital Giessen, Germany
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, University Hospital Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, University Hospital Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, University Hospital Giessen, Germany.,Department of Cardiology, Kerckhoff Clinic GmbH, Germany
| | - Astrid Most
- Department of Cardiology and Angiology, University Hospital Giessen, Germany
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D’Ascenzi F, Fiorentini C, Anselmi F, Mondillo S. Left ventricular hypertrophy in athletes: How to differentiate between hypertensive heart disease and athlete’s heart. Eur J Prev Cardiol 2020; 28:1125-1133. [PMID: 33611377 DOI: 10.1177/2047487320911850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022]
Abstract
Abstract
Athlete’s heart is typically accompanied by a remodelling of the cardiac chambers induced by exercise. However, although competitive athletes are commonly considered healthy, they can be affected by cardiac disorders characterised by an increase in left ventricular mass and wall thickness, such as hypertension. Unfortunately, training-induced increase in left ventricular mass, wall thickness, and atrial and ventricular dilatation observed in competitive athletes may mimic the pathological remodelling of pathological hypertrophy. As a consequence, distinguishing between athlete’s heart and hypertension can sometimes be challenging. The present review aimed to focus on the differential diagnosis between hypertensive heart disease and athlete’s heart, providing clinical information useful to distinguish between physiological and pathological remodelling.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | | | - Sergio Mondillo
- Department of Medical Biotechnologies, University of Siena, Italy
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Martin SA, Hadmaș RM. Individual Adaptation in Cross-Country Skiing Based on Tracking during Training Conditions. Sports (Basel) 2019; 7:sports7090211. [PMID: 31547420 PMCID: PMC6784154 DOI: 10.3390/sports7090211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 11/16/2022] Open
Abstract
Research on heart rate (HR), mean arterial pressure (MAP) and blood pressure (BP) during specific training stages is less common in endurance athletes, whereas resting BP and HR are less studied in relationship to HRmax. In the current study, the objective was to conduct a medium-term HR, BP and MAP analysis while tracking individual training outcomes. The study was conducted during the 2017–2018 season, over 43 days and 1033 km of training volume, on 12 competitive male cross-country ski athletes. One VO2max test was performed 10 days before the start of the training program. After the test, training volume and intensity was preset for each subject, according to the general training methodology. Early morning HR, MAP and BP measurements were taken as part of the basic functional analysis. Training volume was correlated to both distance (p = 0.01, r = 0.85, CI95% = 0.80 to 0.88) and training HR%, namely the percentage of HRmax (p = 0.01, r = −0.47, CI95% = −0.58 to −0.34). Both the supine (sHR) and orthostatic HR (oHR) values were significantly correlated with the training intensity. We obtained a significant correlation between sHR and oHR values and the training objective (p = 0.01). An increased oHR was correlated to high intensity training activity (HIT) during the second training session (p = 0.01). Heart rate and blood pressure measurements represent predictive functional adaptation parameters over different training phases. We highlight a link between sHR, oHR, MAP data, and the athletes’ ability to perform in lower effort zones during physical exertion. However, we failed to validate MAP as a cardiovascular stress indicator following high intensity training.
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Affiliation(s)
- Stefan Adrian Martin
- Physiology Department, University of Medicine Pharmacy Science and Technology Târgu Mureș, Târgu Mureș 540139, Romania.
| | - Roxana Maria Hadmaș
- Community Nutrition and Food Hygiene Department, University of Medicine Pharmacy Science and Technology Târgu Mureș, Târgu Mureș 540139, Romania
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Mahjoub H, Le Blanc O, Paquette M, Imhoff S, Labrecque L, Drapeau A, Poirier P, Bédard É, Pibarot P, Brassard P. Cardiac remodeling after six weeks of high-intensity interval training to exhaustion in endurance-trained men. Am J Physiol Heart Circ Physiol 2019; 317:H685-H694. [PMID: 31347913 DOI: 10.1152/ajpheart.00196.2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
High-intensity interval training (HIIT) improves physical performance of endurance athletes, although studies examining its cardiovascular effects are sparse. We evaluated the impact of HIIT on blood pressure, heart rate, and cardiac cavities' size and function in endurance-trained adults. Seventeen endurance-trained men underwent 24-h ambulatory blood pressure monitoring and Doppler echocardiography at baseline and after 6 wk of HIIT. Participants were divided into 2 groups [85% maximal aerobic power (HIIT85), n = 8 and 115% maximal aerobic power (HIIT115), n = 9] to compare the impact of different HIIT intensities. Ambulatory blood pressure monitoring and cardiac chambers' size and function were similar between groups at baseline. HIIT reduced heart rate (55 ± 8 vs. 51 ± 7 beats/min; P = 0.003), systolic blood pressure (121 ± 11 vs. 118 ± 9 mmHg; P = 0.01), mean arterial pressure (90 ± 8 vs. 89 ± 6 mmHg; P = 0.03), and pulse pressure (52 ± 6 vs. 49 ± 5 mmHg; P = 0.01) irrespective of training intensity. Left atrium volumes increased after HIIT (maximal: 50 ± 14 vs. 54 ± 14 mL; P = 0.02; minimal: 15 ± 5 vs. 20 ± 8 mL; P = 0.01) in both groups. Right ventricle global longitudinal strain lowered after training in the HIIT85 group only (20 ± 4 vs. 17 ± 3%, P = 0.04). In endurance-trained men, 6 wk of HIIT reduced systolic blood pressure and mean arterial pressure and increased left atrium volumes irrespective of training intensity, whereas submaximal HIIT deteriorated right ventricle systolic function.NEW & NOTEWORTHY The novel findings of this study are that 6 wk of high-intensity interval training increases left atrial volumes irrespective of training intensity (85 or 115% maximal aerobic power), whereas the submaximal training decreases right ventricular systolic function in endurance-trained men. These results may help identify the exercise threshold for potential toxicity of intense exercise training for at-risk individuals and ideal exercise training regimens conferring optimal cardiovascular protection and adapted endurance training for athletes.
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Affiliation(s)
- Haïfa Mahjoub
- Department of Medicine, Université Laval, Québec, Canada
| | - Olivier Le Blanc
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Myriam Paquette
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Sarah Imhoff
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Audrey Drapeau
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Paul Poirier
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.,Faculty of Pharmacy, Université Laval, Québec, Canada
| | - Élisabeth Bédard
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Philippe Pibarot
- Department of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
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Hedman K, Moneghetti KJ, Christle JW, Bagherzadeh SP, Amsallem M, Ashley E, Froelicher V, Haddad F. Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodelling. Heart 2019; 105:1223-1230. [PMID: 31142598 DOI: 10.1136/heartjnl-2019-314815] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/26/2019] [Accepted: 04/04/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore blood pressure (BP) in athletes at preparticipation evaluation (PPE) in the context of recently updated US and European hypertension guidelines, and to determine the relationship between BP and left ventricular (LV) remodelling. METHODS In this retrospective study, athletes aged 13-35 years who underwent PPE facilitated by the Stanford Sports Cardiology programme were considered. Resting BP was measured in both arms; repeated once if ≥140/90 mm Hg. Athletes with abnormal ECGs or known hypertension were excluded. BP was categorised per US/European hypertension guidelines. In a separate cohort of athletes undergoing routine PPE echocardiography, we explored the relationship between BP and LV remodelling (LV mass, mass/volume ratio, sphericity index) and LV function. RESULTS In cohort 1 (n=2733, 65.5% male), 34.3% of athletes exceeded US hypertension thresholds. Male sex (B=3.17, p<0.001), body mass index (BMI) (B=0.80, p<0.001) and height (B=0.25, p<0.001) were the strongest independent correlates of systolic BP. In the second cohort (n=304, ages 17-26), systolic BP was an independent correlate of LV mass/volume ratio (B=0.002, p=0.001). LV longitudinal strain was similar across BP categories, while higher BP was associated with slower early diastolic relaxation. CONCLUSION In a large contemporary cohort of athletes, one-third presented with BP levels above the current US guidelines' thresholds for hypertension, highlighting that lowering the BP thresholds at PPE warrants careful consideration as well as efforts to standardise measurements. Higher systolic BP was associated with male sex, BMI and height and with LV remodelling and diastolic function, suggesting elevated BP in athletes during PPE may signify a clinically relevant condition.
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Affiliation(s)
- Kristofer Hedman
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA
| | - Kegan J Moneghetti
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Stanford University, Stanford Sports Cardiology, Stanford, California, USA
| | - Jeffrey W Christle
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Stanford University, Stanford Sports Cardiology, Stanford, California, USA
| | - Shadi P Bagherzadeh
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA
| | - Myriam Amsallem
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA
| | - Euan Ashley
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Stanford University, Stanford Sports Cardiology, Stanford, California, USA
| | - Victor Froelicher
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Stanford University, Stanford Sports Cardiology, Stanford, California, USA
| | - Francois Haddad
- Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA.,Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA
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Description and Comparison of Preseason and Postseason Blood Pressure Measures Among Collegiate Athletes: A Prospective Observational Study. Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Effects of a highly intensive clean and jerk exercise on blood pressure and arterial stiffness in experienced non-professional weight lifters. Eur J Appl Physiol 2019; 119:913-920. [PMID: 30666411 DOI: 10.1007/s00421-019-04080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Weight lifting training has gained much popularity in recent years and is frequently used in non-professional and professional settings. However, little is known about the acute effects of a highly intensive weight lifting exercise (clean and jerk) on the hemodynamic reaction. METHODS 18 non-professional experienced weight lifters were recruited. Hemodynamic parameters were obtained and measured at baseline (T1), after warming up (T2), and after a highly intensive clean and jerk exercise (90-95% of personal best; T3). Further, 15 (T4), and 30 min (T5) post-exercise measurements were conducted. Evaluated parameters were heart rate (HR) (b/min), peripheral and central systolic and diastolic blood pressure (pSysBP, pDiaBP, cSysBP, cDiaBP) (mmHg), pulse wave velocity (PWV) (m/s), and double product (DP). RESULTS All hemodynamic values increased from T1 up to T3 with significantly higher values measured at T3 compared to T1 and T2. Values of measured parameters at T3 were as follows: HR: 94.4 ± 15.6 b/min, pSysBP: 147.1 ± 15.9 mmHg, pDiaBP: 87.4 ± 12.2 mmHg, cSysBP: 129.3 ± 13.8 mmHg, cDiaBP: 89.9 ± 12.8 mmHg, and: 5.8 ± 0.5 m/s, DP: 14053 ± 3669. Post-exercise (T4, T5), all values returned to baseline levels. CONCLUSIONS Results indicate that a highly intensive weight lifting exercise led to an acute increase of blood pressure and an acute stiffening of the arteries. Yet, increases were moderate and did not reach disproportionately high levels and returned to baseline levels within 15 min post-exercise. Hence, no negative acute effects of a maximum weight lifting exercise on the hemodynamic system are observed.
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Silva DV, Waclawovsky G, Kramer AB, Stein C, Eibel B, Grezzana GB, Schaun MI, Lehnen AM. Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: Comparative Cross-Sectional Study. Arq Bras Cardiol 2018; 111:772-781. [PMID: 30281689 PMCID: PMC6263448 DOI: 10.5935/abc.20180167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/02/2018] [Accepted: 07/02/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cardiac remodeling is a specific response to exercise training and time exposure. We hypothesized that athletes engaging for long periods in high-intensity strength training show heart and/or vascular damage. OBJECTIVE To compare cardiac characteristics (structure and function) and vascular function (flow-mediated dilation [FMD] and peripheral vascular resistance [PVR]) in powerlifters and long-distance runners. METHODS We evaluated 40 high-performance athletes (powerlifters [PG], n = 16; runners [RG], n = 24) and assessed heart structure and function (echocardiography), systolic and diastolic blood pressure (SBP/DBP), FMD, PVR, maximum force (squat, bench press, and deadlift), and maximal oxygen uptake (spirometry). A Student's t Test for independent samples and Pearson's linear correlation were used (p < 0.05). RESULTS PG showed higher SBP/DBP (p < 0.001); greater interventricular septum thickness (p < 0.001), posterior wall thickness (p < 0.001) and LV mass (p < 0.001). After adjusting LV mass by body surface area (BSA), no difference was observed. As for diastolic function, LV diastolic volume, wave E, wave e', and E/e' ratio were similar for both groups. However, LA volume (p = 0.016) and BSA-adjusted LA volume were lower in PG (p < 0.001). Systolic function (end-systolic volume and ejection fraction), and FMD were similar in both groups. However, higher PVR in PG was observed (p = 0.014). We found a correlation between the main cardiovascular changes and total weight lifted in PG. CONCLUSIONS Cardiovascular adaptations are dependent on training modality and the borderline structural cardiac changes are not accompanied by impaired function in powerlifters. However, a mild increase in blood pressure seems to be related to PVR rather than endothelial function.
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Affiliation(s)
- Diego Vidaletti Silva
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Gustavo Waclawovsky
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Ana Beatriz Kramer
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
- Faculdade Sogipa de Educação Física, Porto
Alegre, RS - Brazil
| | - Cinara Stein
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Bruna Eibel
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Guilherme Brasil Grezzana
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Maximiliano Isoppo Schaun
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
| | - Alexandre Machado Lehnen
- Instituto de Cardiologia - Fundação
Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil
- Faculdade Sogipa de Educação Física, Porto
Alegre, RS - Brazil
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50
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Ye S, Zhu C, Wei C, Yang M, Zheng W, Gan D, Zhu S. Associations of Body Composition with Blood Pressure and Hypertension. Obesity (Silver Spring) 2018; 26:1644-1650. [PMID: 30260578 DOI: 10.1002/oby.22291] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/02/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The present study investigated the associations of body composition, including skeletal muscle and fat mass, with blood pressure (BP) and hypertension. METHODS Data from 3,130 participants aged 18 to 80 years were analyzed. Body composition and total skeletal muscle (TSM) were measured or calculated based on dual-energy x-ray absorptiometry. Multivariate linear and logistic regression models were used to analyze the associations of TSM, body fat percentage, android to gynoid fat ratio, and leg and arm lean body mass (LBM) with BP and hypertension. The Wald test was used to estimate the differences in the coefficients. RESULTS TSM indices, body fat percentage, and android to gynoid fat ratio were significantly associated with higher odds ratio for prehypertension and hypertension, except for TSM/weight, after controlling for potential confounders. The standardized beta coefficients of arm LBM indices for systolic and diastolic BP were higher than relevant indices of leg LBM. CONCLUSIONS Different indices of TSM, especially in arm LBM, were all positively associated with elevated BP, prehypertension, and hypertension in Chinese adults, after considering potential confounding factors, including body fat and fat distribution. Future longitudinal studies are warranted to confirm our findings.
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Affiliation(s)
- Sunyue Ye
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chaonan Zhu
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Wei
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Min Yang
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weifang Zheng
- Red Cross Hospital of Lanxi City, Lanxi, Zhejiang, China
| | - Da Gan
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shankuan Zhu
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
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