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Effects of Physical Activity on Hypertension of Youth

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Exercise, Sports and Hypertension

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Sedentary habits leading to obesity and metabolic disturbances are responsible for the rise in the prevalence of hypertension among adolescents and young individuals. Regular aerobic exercise has been shown to reduce blood pressure (BP) in resting conditions and BP reactivity to stressors, and to improve all components of the metabolic syndrome. Beneficial effects of physical activity have been observed also on hypertension-mediated organ damage. Some studies have documented a paradoxical effect of exercise on the hypertensive heart with a reduction rather than an increase of left ventricular mass. Results of the HARVEST study have shown that even high-intensity exercise has beneficial effects on the structure of the left ventricle in young hypertensive athletes. In addition, regular physical activity has been found to retard the progression of subclinical atherosclerosis and to improve arterial distensibility. Although the pathogenesis and the prognostic significance of isolated systolic hypertension in youth are still controversial, in physically active young people systolic hypertension is often considered an innocent clinical condition caused by elevated stroke volume and increased pulse pressure amplification due to low wave arterial reflection from peripheral sites. An exaggerated BP response during exercise testing can be found in normotensive subjects and is thought to be due to a failure to reduce total peripheral resistance adequately during exercise. Several prospective studies have demonstrated that excessive increases in BP during exercise may be a marker of future sustained hypertension and of increased risk of cardiovascular mortality. Studies performed in young borderline hypertensive subjects have demonstrated that BP level during steady-state long-lasting exercise are unrelated to the maximum BP attained during traditional stress testing. During a type of exercise simulating a true sport activity a smaller BP increase occurs in hypertensive than in normotensive subjects at peak exercise and the BP level reached at peak exercise is not proportional to baseline pretest BP. A large body of evidence supports a strategy of exercise training in the management of young sedentary patients in the early stages of hypertension. However, caution should be used in subjects with more severe hypertension and every hypertensive athlete should be thoroughly investigated to exclude target organ damage and coronary artery disease. Pharmacological treatment should be used to normalize office and out-of-office BP, and competitions should be postponed until BP measurements return within the normal range.

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P.P. performed the design of the study, data collection and analysis, manuscript writing and revision.

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All human studies whose data have been used for the present chapter have been reviewed by the appropriate ethics committees and have been performed in accordance with the ethical standards of the 1964 Declaration of Helsinki.

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  1. Department of Medicine, Studium Patavinum, University of Padova, Padova, Italy

    Paolo Palatini

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  1. Studium Patavinum, University of Padova, Padova, Italy

    Paolo Palatini

  2. Dept of Clinical and Experimental Sci, University of Brescia, Brescia, Italy

    Enrico Agabiti-Rosei

  3. Emeritus Professor, University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Palatini, P. (2022). Effects of Physical Activity on Hypertension of Youth. In: Palatini, P., Agabiti-Rosei, E., Mancia, G. (eds) Exercise, Sports and Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-07958-0_11

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