Participation in High-Static, Low-Dynamic Demand Sports Increases Prevalence of Elevated Blood Pressure in Adolescent Athletes

Purpose: Hypertension is a growing public health concern. While physical activity is generally beneficial, the role of varying physiologic demand on elevated blood pressure risk in adolescents is not well understood. This study evaluates the relationships between blood pressure in athletes and the physiologic demands of their sports. Methods: A total of 7127 adolescent athletes (ages 13–19) were included in a retrospective analysis of blood pressure measurement during preparticipation evaluation. Sports were classified by high or low demand for static and dynamic components. Binomial logistic regression was completed to assess associations between static and dynamic components and elevated blood pressure screening. Differences in mean blood pressures (analysis of variance) and prevalence of elevated blood pressure (chi-square test) were assessed between high and low demand sports participation. Results: Participation in sports with a high-static or low-dynamic demand showed high rates of elevated blood pressure. Athletes in high-static demand sports had 1.6 times greater odds of elevated blood pressure screening ( P < 0.0001); high-dynamic demand was associated with reduced odds (0.75, P = 0.006). The combination of high-static and low-dynamic demand resulted in the highest prevalence (17.5%). Mean systolic blood pressure was higher among high-static and low-dynamic participants, while diastolic pressure was not significantly different. Conclusions: Athletes participating in sports with high-static or low-dynamic demands have a higher risk of elevated blood pressure. This suggests a need for sport-specific cardiovascular assessment and consideration of training modifications to reduce long-term cardiovascular risk. Longitudinal studies are warranted to evaluate the persistence of elevated blood pressure and clinical implications.