Medpagetoday.com
REPORTS HERE that "competitive sports aren't off limits for most children with
hypertension, according to updated guidelines from the American Academy
of Pediatrics. However, temporary restriction from strenuous sports may be required
for student athletes with stage 2 hypertension to reduce risk of
cerebrovascular accidents, Rebecca A. Demorest, MD, of Children's
Hospital Oakland in Oakland, Calif., and colleagues wrote in the June
issue of
Pediatrics.
"In the absence of left ventricular hypertrophy, concomitant heart
disease, or other end organ damage, these kids can return to competitive
athletics after lifestyle measures or medications bring blood pressure
back into the normal range, the policy statement said. No restrictions are needed for those with stage 1 hypertension that
reaches at least the 95th percentile for age and height but not more
than 5 mm Hg over the 99th percentile (the threshold for stage 2) if
there are no signs of end organ damage. The same holds true for kids with prehypertension, although those
with blood pressure between the 90th and 95th percentile need blood
pressure checks every six months, Demorest's group noted."
"Lifestyle modifications, including daily physical activity and a
balanced diet, was recommended for all three groups as well as for
normotensive kids during well-child visits. Regular, noncompetitive physical activity can be encouraged as an
effective strategy to reduce both systolic and diastolic pressures in
those with hypertension, the guidelines state."
"Young athletes with hypertension, in particular, should be urged to
avoid substances that could affect blood pressure, including excessive
consumption of energy drinks and caffeine and any exogenous androgens,
growth hormones, illicit drugs, alcohol, tobacco in all its forms,
nonprescribed stimulants, or over-the-counter supplements that contain
ephedra or other stimulants."
"Sodium restriction is typically recommended in adult hypertension,
but kids participating in competitive sports may need salt-containing
sports drinks and other salty foods to stay hydrated after extensive
sweating, the statement noted."
"It cautioned that student athletes should be advised that
antihypertensive diuretics and beta-blockers are on the prohibited list
of some athletic governing bodies and that these medications can
decrease athletic performance for some individuals."
"Careful diagnosis is needed in all cases, with multiple measurements
to confirm elevated blood pressure and use of a correctly sized blood
pressure cuff, the AAP urged."
"But greater care in diagnosing and monitoring hypertension was called
for in at-risk populations, which includes obese student athletes. 'In certain sports and team positions, bulk and body mass are valued,
expected, and promoted,' Demorest's group wrote in the statement. 'This
practice should not be encouraged because of the health risks
associated with obesity, including but not limited to hypertension,
cardiovascular disease, diabetes, dyslipidemia, and arthritis'."
"Another at-risk group is athletes with spinal cord injuries, which
can cause difficulties in regulating blood pressure. 'In these athletes, hypertension may be a sign of autonomic
dysreflexia (uncontrolled systemic sympathetic response) as a result of
pain, illness, infection, or bowel or bladder distension,' the guideline
writers noted, emphasizing that intentionally inducing this effect can
cause serious health problems."
