Occult hypertension on ambulatory monitoring was associated with CAC score ≥100 AU (OR 2.56; 95% CI 1.08-6.04) and coronary stenosis >50% (OR 2.92; 95% CI 1.17-7.33) in male endurance athletes.
Cross-Sectional (n=198)
Does occult resting or exercise-induced hypertension associate with increased coronary atherosclerosis in male masters endurance athletes?
Occult resting and exercise-induced hypertension are highly prevalent in male masters endurance athletes and are significantly associated with high-risk features of coronary atherosclerosis.
Effect estimate: OR 2.56 (95% CI 1.08 to 6.04)
Objective Recent studies have demonstrated a greater prevalence of coronary atherosclerosis in male masters endurance athletes, but the underlying contributors remain unclear. We explored the relationship between occult resting and exercise-induced hypertension with coronary atherosclerosis characteristics. Methods 198 male masters endurance athletes with a low Framingham risk score (50%. Sixty-two athletes (31%) had calcified plaque, 32 (16%) had mixed plaque, 2 (1%) had non-calcified plaque and 26 (13%) had markers of high-risk plaque. Hypertension on ABP monitoring was significantly associated with a CAC score ≥100 AU (OR: 2.56; 1.08 to 6.04) and coronary stenosis >50% (OR: 2.92; 1.17 to 7.33). A hypertensive response to exercise was significantly associated with coronary stenosis >50% (OR: 4.72; 1.65 to 13.5) and the presence of high-risk plaque (OR: 3.27; 1.27 to 8.43). Conclusion Masters male endurance athletes have a high prevalence of occult hypertension, which is associated with high-risk features of coronary atherosclerosis. Both ambulatory and exercise-induced hypertension are associated with a higher prevalence of atherosclerotic coronary artery disease in male endurance athletes. Early identification and timely clinical management of this classic cardiovascular disease risk factor may reduce the burden of coronary atherosclerosis in athletes.
O’Driscoll et al. (2026) conducted a cross-sectional in Coronary atherosclerosis and occult hypertension (n=198). Occult hypertension (ambulatory and exercise-induced) vs. Normotensive athletes was evaluated on CAC score ≥100 AU (OR 2.56, 95% CI 1.08 to 6.04). Occult hypertension on ambulatory monitoring was associated with CAC score ≥100 AU (OR 2.56; 95% CI 1.08-6.04) and coronary stenosis >50% (OR 2.92; 95% CI 1.17-7.33) in male endurance athletes.