Cardiovascular risk factors and blood pressure response to various types of exercise in veteran athletes

Aim. To study the main cardiovascular risk (CVR) factors and assess the blood pressure (BP) response to various types of exercise in veteran athletes.

Material and methods. In order to identify the main CVR factors, 234 competitive athletes and 29 persons practicing physical training were interviewed. We also measured their pre- and post-exercise BP. The previously diagnosed hypertension (HTN) was also taken into account.

Results. Among the participants, HTN was diagnosed in 48,5% of athletes, obesity — in 21%, smoking — in 22,9%, while 15,5% had a positive family history of coronary artery disease. The combination of two or more studied risk factors was observed in 35,7% of the subjects. The prevalence of the studied risk factors in participants significantly depended on the type of physical activity. The most unfavorable situation was obtained among hockey players. The highest pre-exercise diastolic BP values were registered in football players (p<0,05), while after exercise, in hockey and football players. In persons with obesity and HTN, the pre- and post-exercise systolic and diastolic BP, as well as the double product, were significantly (p<0,05) higher than in those without HTN and obesity.

Conclusion. Veteran athletes practically do not differ from the general population in prevalence of HTN, smoking, and obesity. Elevated pre-and post-exercise BP values (>139/89 mm Hg) was recorded in >40% of veteran athletes. The highest BP levels were found among volleyball and football players. The factors predisposing to such an increase in pre- and post-exercise BP in veteran athletes are obesity, diagnosed HTN, and a positive family history of coronary artery disease. There is reason to consider BP >139/89 mm Hg in the early recovery period as an unfavorable indicator.

1. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension [published correction appears in Eur Heart J. 2019;40(5):475]. Eur Heart J. 2018;39(33):3021-104. doi:10.1093/eurheartj/ehy339.

2. Hegde SM, Solomon SD. Influence of Physical Activity on Hypertension and Cardiac Structure and Function. Curr Hypertens Rep. 2015;17(10):77. doi:10.1007/s11906-015-0588-3.

3. WHO Global action plan on physical activity and health 20182030: More active people for a healthier world. 4 June 2018 News Release Lisbon, Portugal. https://www.who.int/news-room/detail/04-06-2018-who-launches-global-action-plan-on-physical-activity.

4. WHO Global Strategy on Diet, Physical Activity and Health. What is Moderate-intensity and Vigorous-intensity Physical Activity. https://www.who.int/dietphysicalactivity/factsheet_adults/en/.

5. Laukkanen JA, Khan H, Kurl S, et al. Left ventricular mass and the risk of sudden cardiac death: a population-based study. J Am Heart Assос. 2014;5;3(6):e001285. doi:10.1161/JAHA.114.001285.

6. Lippi G, Favaloro EJ, Sanchis-Gomar F. Sudden Cardiac and Noncardiac Death in Sports: Epidemiology, Causes, Pathogenesis, and Prevention. Seminars in Thrombosis and Hemastasis. 2018;44(8):780-6. doi:10.1055/s-0038-1661334.

7. Black HR, Sica D, Ferdinand K, White WB; American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 6: Hypertension: A Scientific Statement from the American Heart Association and the American College of Cardiology. Circulation. 2015; 1;132(22):e298-302. doi:10.1161/CIR.0000000000000242.

8. Mitchell JH, Haskell W, Snell P, Van Camp SP. Task Force 8: classification of sports. J Am Coll Cardiol. 2005;45(8):1364-7. doi:10.1016/j.jacc.2005.02.015.

9. De Marco M, de Simone G, Roman MJ, et al. Cardiovascular and Metabolic Predictors of Progression of Prehypertension into Hypertension: The Strong Heart Study. Hypertension. 2009;54(5):974-80. doi:10.1161/HYPERTENSIONAHA.109.129031.

10. Niebauer J, Borjesson M, Carre F, et al. Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2018;39(40):3664-71. doi:10.1093/eurheartj/ehy511.

11. Boytsov SA, Balanova YuA, Shalnova SA, et al. Hypertension among people aged 25-64 years prevalence, awareness, treatment and control. Based on the essay study. Cardiovascular Therapy and Prevention. 2014;13(4):4-14. (In Russ.)

12. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. Prevalence of risk factors for noncommunicable diseases in the Russian population in 2012-2013. The results of the study ESSE-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4-11. (In Russ.)

13. Rodriguez CJ, Sacco RL, Sciacca RR, et al. Physical activity attenuates the effect of increased left ventricular mass on the risk of ischemic stroke: The Northern Manhattan Stroke Study. J Am Coll Cardiol. 2002;1;39(9):1482-8. doi:10.1016/S0735-1097(02)01799-0.

14. Laukkanen JA, Jennings JR, Kauhanen J, et al. Relation of systemic blood pressure to sudden cardiac death. Am J Cardiol. 2012;1;110(3):378-82. doi: 10.1016/j.amjcard.2012.03.035.

15. Smolenskiy AV, Mikhailova AV, Belichenko OI, et al. Arterial hypertension in athletes. Questions for diagnosis and approaches to treatment. J Therapist. 2016;5:28-37. (In Russ.)

16. Vyalova MO, Shvarts YuG. Arterial hypertension during sports and fitness in middle-aged and elderly people. Psychosomatic and integrative research. 2020;6:0104. (In Russ.)

17. Vyalova MO, Schwartz YuG. Arterial hypertension and cardiovascular risk indicators in middle-aged and elderly people involved in sports. Cardiology: News. Opinions. Teaching, 2019);2(21):36-44. (In Russ.)

18. Lovic D, Narayan P, Pittaras A, et al. Left ventricular hypertrophy in athletes and hypertensive patients. J Clin Hypertens (Greenwich). 2017;19(4):413-7. doi:10.1111/jch.12977.

19. Caselli S, Vaquer Sequi A, Lemme E, et al. Prevalence and Management of Systemic Hypertension in Athletes. Am J Cardiol. 2017;119(10):1616-22. doi:10.1016/j.amjcard.2017.02.011.