Information about a piece of news titled Surprising results of high ambulatory blood pressure among professional football players
Surprising results of high ambulatory blood pressure among professional football players
Intoduction
Almost by coincidence and for the first time, researchers detected hypertension - both night and day - in professional football players in Norway. These striking data are now published in the British Journal of Sports Medicine.
In 2008, almost 600 male football players from the two highest divisions of professional football play were screened for cardiac risk whileattending a training-camp in La Manga, Spain.
Association between high blood pressure and heart size
- We found a significant association between increased blood pressure and heart size, summarized physician and PhD candidate Hilde Moseby Berge and refers to an article recently published in the Journal of Hypertension.
These findings suggest that high blood pressure may increase the risk of cardiovascular disease even in athletes, and as we also know that a randomly measured high blood pressure at a young age can increase the risk of high blood pressure in older age, the Norwegian research team wondered if the 39 (7%) players from the La Manga camp, identified with hypertension, had controlled blood pressure back home in Norway.
24-hour blood pressure recording
- Thus, in 2010, we implemented a follow-up study and started the 24-hour ambulatory blood pressure recording of 26 (93%) of those 28 players still playing in Norway.
- Our hypothesis was that players with high blood pressure are more stimulated by the sympathetic nervous system (are more "excited") than those with low blood pressure.
We therefore also included 26 players with normal blood pressure (<120/70 mm Hg) to collect data from a control group, Moseby Berge adds.
Only one player, on his own initiative, measured blood pressure in GP after returning home, while 62% had controlled blood pressure at the club's annual health check.
The remaining players had no follow-up.
As expected, several of the players, 11 out of 26 (42%) suffered from "white coat hypertension": a high blood pressure in the office while low for the rest of the day.
9 out of 26 players with masked hypertension
Surprisingly, and now being published in the British Journal of Sports Medicine, more than a third, 9 out of the 26 players with low blood pressure in the office, had high blood pressure (≥135/85 mm Hg) during the rest of the day. This phenomenon is called “masked hypertension” and is known as a risk factor for cardiovascular diseases.
Hilde Moseby Berge, first author of these studies and a specialized in family medicine, has extensive experiences in measuring blood pressure.
- But I've never before conducted a 24-hour blood pressure recording of individuals with normal blood pressure in the office. At first, I thought that there was something wrong with the testing procedures, as the mean blood pressure was high, too, in both groups, and 3/4 of the players had high blood pressure (≥120/75 mm Hg) during the night.
- After an additional control of the blood pressure devices, we must trust that these findings are representative for professional football in Norway, says Moseby Berge.
Reasons unknown
- Based on our study, we unfortunately cannot draw any conclusions about the cause of the high blood pressure. It is possible that football players have a particular "sympathetic drive", caused by the training volume and intensity, competition for playing time, or too little time to rest.
- We do not know if masked hypertension is a risk factor for cardiovascular diseases in young and well-trained football players, as other mechanisms can be involved here.
It also remains to be answered whether these findings can be generalized to other athlete populations, if they suffer from a comparable prevalence of masked hypertension.
Recommendations
Moseby Berge and co-workers are looking forward to find an answer to this question and are planning a large cohort study to follow athletes over time.
So long, they recommend a new office blood pressure test after detection of high blood pressure during preparticipation screening, complemented by a 24-hour ambulatory blood pressure recording, when EKG is suggestive of increased heart size and when other known risk factors for high blood pressure are present.
Cardiac screening was initiated by the team physician in football, Thor Einar Andersen, in collaboration with cardiologists Kjetil Steine and Erik Ekker Solberg.
Download the article in the British Journal of Sports Medicine.