Hypertension (High Blood Pressure)

Hypertension is the medical term for higher than normal blood pressure. Hypertension occurs in people of all ages, but is common as a persistent problem when people age. There are many times when blood pressure increases above "normal" levels, such as during exercise or when afraid. However, after these periods, blood pressure returns to normal levels. Persistent (chronic) hypertension makes the heart, kidneys, and blood vessels work harder. This puts people with hypertension at an increased risk for heart attack, stroke, kidney disease, and peripheral vascular disease (obstruction of arteries). There are two types of hypertension: essential and unessential. Up to 70% of affected people have essential hypertension, which means the reason for their disease is unknown.

SYMPTOMS

  • Hypertension often has no symptoms, especially in the early stages of the disease.

  • Headache.

  • Nosebleeds.

  • Numbness and tingling of the hands and feet (paresthesis).

  • Shortness of breath.

  • Rapid heart rate, felt in chest (palpitations).

  • Decrease in athletic performance.

CAUSES

  • Anabolic steroid use.

  • Stimulants (caffeine, cocaine, Ma-huang, phenyl-propanolamine, amphetamines).

  • Obesity.

  • Kidney disease.

  • Diseases of the adrenal glands.

  • Too much alcohol use.

  • Too much sodium (salt) intake.

  • Narrowing of the large blood vessels of the body (coarctation of the aorta).

  • Vascular disease.

RISK INCREASES WITH:

  • Obesity.

  • Inactive lifestyle.

  • Use of anabolic steroids.

  • High sodium diet.

  • Use of stimulants (cocaine, Ma-huang, amphetamines, ephedrine).

  • Too much alcohol use.

  • Family history of hypertension.

  • Age (especially older than 60).

PREVENTION

  • Hypertension cannot be prevented, only controlled.

  • Good control prevents complications and improves athletic performance.

  • To prevent hypertension from getting out of control:

  • Avoid drinking too much alcohol.

  • Avoid excessive use of stimulants.

  • Be sure that intense exercise does not worsen blood pressure.

  • Do not smoke.

  • Avoid isometric exercises.

  • Do not hold breath when lifting weights. Exhale during the difficult part of the lift.

PROGNOSIS

  • Without proper treatment, hypertension can shorten the life span and reduce quality of life.

  • If treated properly, hypertension does not affect quality of life or life expectancy, and athletes can maintain their level of play.

  • Life expectancy is normal or close to normal, with good control of blood pressure.

RELATED COMPLICATIONS

  • Heart attack.

  • Stroke.

  • Kidney failure.

  • Heart failure.

  • Poor tolerance of exercise.

TREATMENT

  • Diagnostic tests may be given to determine a cause for hypertension. These tests include an electrocardiogram (ECG), blood tests, chest x-rays, and 24-hour monitoring of blood pressure to confirm readings. In some cases, studies to visualize the kidneys may be performed.

  • First, treatment involves diet modification (reducing sodium and alcohol intake), exercise, and weight loss. If hypertension is not under control after 3 to 6 months, medicines may be given to lower blood pressure.

  • Patients should stop smoking.

  • Athletes should learn to monitor their own blood pressure.

MEDICATIONS

  • Medicines, such as hydrochlorothiazide, may be given to lower blood pressure, if lifestyle changes are not enough alone.

  • Blood pressure medicines may affect athletic performance in different ways. Athletes should consider side effects before choosing a hypertension medicine.

ACTIVITY

  • Studies have shown that regular physical activity improves blood pressure control.

  • Moderate cardiovascular exercise (i.e. brisk walking) may be best for control of hypertension.

  • Certain high intensity exercises (i.e. weight training) may increase resting blood pressure. Some caregivers may advise athletes to stop strength training until blood pressure is reduced.

  • Circuit training has been shown to be safe for athletes with hypertension.

DIET

  • Athletes should consider a low sodium diet, but should watch for heat cramps with exercise.

  • Athletes who are overweight should try to reduce weight.

SEEK MEDICAL CARE IF:

  • Medicines are poorly tolerated.

  • Athletic performance decreases suddenly or does not improve with treatment.

  • Chest pain, shortness of breath, or heart palpitations occur with exercise.