Hypertension, cardiovascular risk and exercise in middle-aged and elderly people: a narrative review

Hypertension (HTN) is widespread among middle-aged and elderly people, including those doing sports. For the first time in 2020, the European Society of Cardiology guidelines on sports cardiology and exercise in patients with cardiovascular disease included adult and elderly patients in a separate group. However, this is a heterogeneous category of patients, including everyone over 35 years of age. Therefore, admittance of athletes to training and competitions still remains at the discretion of physician.Aim. To assess the relationship and mutual influence of hypertension, other cardiovascular risk factors and sports in middle-aged and elderly people.Material and methods. Our narrative review is based on 50 articles published on Pubmed, Scopus, Web of Science and eLIBRARY.ru, selected using the keywords "veteran athletes", "arterial hypertension", "cardiovascular risk", "physical activity". Related papers over the past 5 years were evaluated.Results. Currently, there is a trend toward an increase in the number of veteran athletes whose problems are not reflected in guidelines on sports and exercise.Conclusion. In the future, large randomized studies are needed to assess the response of blood pressure (BP) to intense exercise, as well as to determine the normal BP response and clear strategy to manage this category of people, depending on the presence of hypertension.