Document Detail


Hypertension update and cardiovascular risk reduction in physically active individuals and athletes.
MedLine Citation:
PMID:  20424397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension is a prevalent disease worldwide. Its inadequate treatment leads to major cardiovascular complications, such as myocardial infarction, stroke, and heart failure. These conditions decrease life expectancy and are a substantial cost burden to health care systems. Physically active individuals and professional athletes are not risk free for developing this condition. Although the percentage of persons affected is substantially lower than the general population, these individuals still need to be thoroughly evaluated and blood pressure targets monitored to allow safe competitive sports participation. Regarding treatment, lifestyle modification measures should be routinely emphasized to athletes and active individuals with the same importance as for the general population. Medication treatment can be complicated because of restrictions by athletic organizations and possible limitations on maximal exercise performance. In addition, the choice of an antihypertensive drug should be made with consideration for salt and water losses that routinely occur in athletes, as well as preservation of exercise performance and endothelial function. First-line therapies for athletes and physically active individuals may be different from the general population. Some authorities believe that blocking the renin-angiotensin system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) is more beneficial compared with diuretics because of ACE inhibitors and ARBs being able to avoid salt and water losses. Dihydropyridine calcium channel blockers (CCBs) are another reasonable choice. Despite effects on heart rate, nondihydropyridine CCBs do not appear to impair exercise performance. beta-Blockers are not used as a first-line therapy in athletes because of effects on exercise and prohibition by the National Collegiate Athletic Association and World Anti-Doping Agency in certain sports. In this article, we address the evidence on hypertension and its related treatments in active individuals to provide recommendations that allow the best competitive sports results and reduce cardiovascular risk.
Authors:
Leonardo P J Oliveira; Christine E Lawless
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Physician and sportsmedicine     Volume:  38     ISSN:  0091-3847     ISO Abbreviation:  Phys Sportsmed     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0427461     Medline TA:  Phys Sportsmed     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-20     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / adverse effects,  therapeutic use
Athletes*
Drug Therapy, Combination
Endothelium, Vascular / physiopathology
Female
Humans
Hypertension / classification,  pathology,  physiopathology,  therapy*
Hypertrophy, Left Ventricular / pathology
Male
Physical Endurance / drug effects
Risk Reduction Behavior
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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