Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technical University of Munich.
DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance.
J Hypertens. 2018 Sep;36(9):1803-1809. doi: 10.1097/HJH.0000000000001791.
Exaggerated blood pressure (BP) response to exercise testing has been linked to left ventricular hypertrophy and myocardial fibrosis in competitive athletes. Due to frequent training, athletes are particularly exposed to high BP levels, but data on the magnitude and distribution of BP response to exercise in athletic populations is scarce.
Cycle ergometry was performed in 2419 healthy competitive adolescent, professional and master athletes (age 26 ± 12 years, range 9-74, 27% women, 84 disciplines) for preparticipation screening. Fulfilling both subjective and at least two out of three objective exhaustion criteria (maximal heart rate >85% predicted, lactate ≥7 mmol/l, rate of perceived exertion ≥17) was required. Echocardiography was also performed.
Maximal workload was 305 ± 59 W (mean ± SD) in men and 218 ± 40 in women. SBP increased significantly (men, Δ80 ± 20; women, Δ67 ± 16 mmHg; P < 0.001) to 204 ± 22 (men) and 180 ± 17 mmHg (women). DBP changed minimally (men: Δ0 ± 9, women: Δ2 ± 8 mmHg). The upper normative limit of SBP in men was 247 [95% CI 245-249; women: 214 (212-216) mmHg]. ESC guidelines of upper limits of maximal SBP were exceeded in 43% in men (>210 mmHg) and 28% in women (>190 mmHg). SBP response was more pronounced in endurance athletes, whereas DBP was slightly higher in strength athletes. Among cardiac dimensions, the strongest association for maximal SBP was found for left ventricular mass (r = 0.489; P < 0.001).
SBP response to exercise testing is markedly exaggerated particularly in male endurance athletes. The prognostic significance of these findings regarding long-term cardiovascular alterations requires further clarification.
运动试验时血压（BP）反应过度与竞技运动员的左心室肥厚和心肌纤维化有关。由于经常训练，运动员特别容易受到高血压水平的影响，但关于运动时 BP 反应的幅度和分布在竞技人群中的数据很少。
对 2419 名健康的竞技青少年、专业和大师运动员（年龄 26±12 岁，范围 9-74 岁，27%为女性，84 项运动）进行了赛前筛查。需要同时满足主观和至少三个客观衰竭标准（最大心率>85%预测值，乳酸≥7mmol/l，感知用力程度≥17）。还进行了超声心动图检查。
男性最大工作量为 305±59W（均值±标准差），女性为 218±40W。SBP 显著升高（男性，Δ80±20mmHg；女性，Δ67±16mmHg；P<0.001），分别达到 204±22mmHg（男性）和 180±17mmHg（女性）。DBP 变化很小（男性：Δ0±9mmHg；女性：Δ2±8mmHg）。男性 SBP 的正常上限值为 247[95%CI 245-249；女性：214（212-216）mmHg]。男性超过 ESC 指南最大 SBP 上限的占 43%（>210mmHg），女性占 28%（>190mmHg）。耐力运动员的 SBP 反应更为明显，而力量运动员的 DBP 略高。在心脏结构中，最大 SBP 与左心室质量的相关性最强（r=0.489；P<0.001）。
运动试验时 SBP 反应明显过度，尤其是男性耐力运动员。这些发现对长期心血管改变的预后意义需要进一步澄清。
