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Arterial hypertension is one of the major treatable cardiovascular risk factors (1). It is associated with elevated mortality and the incidence of heart insufficiency, myocardial infarcts, and apolex (2). Elevated blood pressure in highperformance athletes is one of the most significant risk factors for cardiovascular diseases (3). Exaggerated blood pressure response to exercise testing is commonly regarded as a predictor of developing overt hypertension (4, 5). However, findings in adults are inconsistent (6), and no commonly accepted upper limits indicative of increased risks have been defined so far (7). There are only a few recommendations for tolerable upper blood pressure limits in exercise testing (8, 9). In the Guidelines of the European Society of Cardiology (ESC), it states that an exceeding systolic blood pressure (SB) of 210 mmHg in men and 190 mmHg in women has been termed “exercise hypertension” (7). In the American Heart Association (AHA) guideline for exercise testing (10) a limit of 214 mmHg (based on the 90th percentile calculated from >27,000 treadmill tests (11) is reported beyond which the risk of developing hypertension appears particularly increased (7). Compared to adults, the prevalence of elevated blood pressure in children and adolescents is clearly lower. However, there is a correlation between elevated blood pressure in children and relation to obesity. In contrast to the recommended upper blood pressure limits in adults, the definition of arterial hypertension in children and adults is based on body height and age-dependent limits. These blood pressure limits are determined in healthy children and adolescents. However, such blood pressure limits do not exist for young highperformance athletes, who are exposed to frequent exerciseinduced blood pressure increase. There is only limited data available in which the effects of exercise-induced blood pressure elevation have been investigated in children and adolescents. Furthermore, very little is known about the exercise-induced blood pressure response in children. The study by Wanne et al. (12) investigated the blood pressure response under maximal dynamic movement in 497 healthy 9 to 18-year-old on a treadmill in young non- athletes. They described higher systolic values in postpuberty youths than in prepuberty. Szmigielska et al. (13) examined 711 (age 10– 18 y) young athletes (training load 7.62 h ± 4.2 h per week). In the maximal testing on the bike ergometer, the SBP was significantly higher in boys than in girls (183.2 ± 27.9 mmHg vs. 170.9 ± 21.4 mmHg, p = 0.03). Description of normative response to physical exercise in healthy children and adolescents in terms of percentiles was just recently given by Sasaki et al. and Clark and al. In the study by Clarke and collegues normative percentiles of blood pressure response on a treadmill for healthy children and adolescents were described (14) in contrast to resting blood pressure and individual height which was not considered in the study by Sasaki et al. (15) Although exercise testing in young elite athletes is frequently performed during preparticipation screenings, very little is known about the “normal” magnitude and distribution of exercise-induced blood pressure in this cohort. Therefore, this study aimed to evaluate the magnitude and determinants of blood pressure response to dynamic exercise testing in young elite athletes. |
