Determinants of Longitudinal Changes in Exercise Blood Pressure in a Population of Young Athletes: The Role of BMI.

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Development and Disease Pub Date : 2025-02-15 DOI:10.3390/jcdd12020074

Francesca Battista, Marco Vecchiato, Kiril Chernis, Sara Faggian, Federica Duregon, Nicola Borasio, Sara Ortolan, Giacomo Pucci, Andrea Ermolao, Daniel Neunhaeuserer

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Abstract

Aim: Higher exercise blood pressure in adults correlates with many cardiometabolic markers. The aim of this study was to investigate the main determinants of longitudinal variations in exercise blood pressure in young athletes.

Methods: A longitudinal retrospective study was conducted on adolescent athletes who underwent at least two sport-related pre-participation screening visits, including exercise testing with a standardized incremental ramp protocol on treadmill. Blood pressure was assessed at rest (SBP_rest), at the 3rd minute of exercise (SBP_3min), and at peak exercise (SBP_peak). Predictors of blood pressure response (i.e., respective changes vs. baseline (Δ)) were determined by multivariate regression models after adjustment for age, sex, follow-up duration, related baseline SBP values, characteristics of sport, and ΔBMI.

Results: A total of 351 young athletes (mean age at baseline 13 ± 2 years, 54% boys, average follow-up duration 3.4 ± 2.2 years) were enrolled. BMI increased by 1.5 ± 1.8 kg/m² (p < 0.001) during follow-up. At baseline, mean SBP_rest was 103 ± 14 mmHg, mean SBP_3min 124 ± 18 mmHg, and mean SBPpeak 154 ± 23 mmHg. A significant between-visit increase in SBP_rest (ΔSBP_rest 7.0 ± 17.4 mmHg; p < 0.001), ΔSBP_3min (4.8 ± 11 mmHg, p < 0.001), and ΔSBP_peak (11.7 ± 24 mmHg, p < 0.001) was observed. ΔSBP_3min was significantly predicted by male sex (p < 0.01), baseline BMI (p < 0.01), ΔBMI (p < 0.01), and number of practiced sports (p < 0.05), whereas ΔSBP_peak was positively predicted by male gender (p < 0.01), baseline BMI (p < 0.05), and ΔBMI (p < 0.01) and negatively by baseline resting heart rate (p < 0.01). In a logistic regression model, ΔBMI was the only independent determinant of passing from a lower to an upper quartile of SBP_3min (p < 0.001), while ΔBMI and male sex were independent determinants of moving to a higher quartile of SBP_peak (p < 0.001).

Conclusions: Increase in BMI during development and male sex are independent determinants of the increase in exercise blood pressure, both at light and maximal intensity, in a population of adolescent athletes.

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青少年运动员运动血压纵向变化的决定因素：BMI的作用。

目的：成人运动血压升高与许多心脏代谢标志物相关。本研究的目的是调查年轻运动员运动血压纵向变化的主要决定因素。方法：对青少年运动员进行了一项纵向回顾性研究，这些运动员至少进行了两次与运动相关的参与前筛查，包括在跑步机上进行标准化增量坡道方案的运动测试。在静息（SBPrest）、运动第3分钟（SBP3min）和运动高峰（SBPpeak）时评估血压。在调整年龄、性别、随访时间、相关基线收缩压值、运动特征和ΔBMI后，通过多变量回归模型确定血压反应的预测因子（即各自的变化与基线（Δ））。结果：共纳入351名年轻运动员（平均基线年龄13±2岁，54%为男孩，平均随访时间3.4±2.2年）。BMI在随访期间增加1.5±1.8 kg/m2 （p < 0.001）。基线时，平均SBPrest为103±14 mmHg，平均SBP3min为124±18 mmHg，平均SBPpeak为154±23 mmHg。两组间SBPrest显著升高(ΔSBPrest 7.0±17.4 mmHg；p < 0.001)， ΔSBP3min(4.8±11 mmHg, p < 0.001)， ΔSBPpeak（11.7±24 mmHg, p < 0.001）。男性性别（p < 0.01）、基线BMI （p < 0.01）、ΔBMI （p < 0.01）、运动次数（p < 0.05）显著预测ΔSBP3min，男性性别（p < 0.01）、基线BMI （p < 0.05）、ΔBMI （p < 0.01）显著预测ΔSBPpeak，基线静息心率（p < 0.01）显著预测ΔSBPpeak。在逻辑回归模型中，ΔBMI是SBP3min从低四分位数过渡到高四分位数的唯一独立决定因素（p < 0.001），而ΔBMI和男性性别是SBP3min向高四分位数移动的独立决定因素（p < 0.001）。结论：在青少年运动员人群中，发育期间BMI和男性的增加是运动血压升高的独立决定因素，无论是在轻强度还是最大强度下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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