Many young athletes risk having hypertension, which could lead to future cardiovascular complications, according to research recently presented at the American College of Cardiology’s Care of the Athletic Heart conference in Washington, D.C.

High blood pressure is common, affecting about 47% of adults, according to a news release from the organization, which cited “Over time, hypertension weakens the heart, blood vessels and kidneys, paving the way for potential stroke or heart attack. Often referred to as the ‘silent killer,’ high blood pressure is a leading risk factor for heart disease and early death,” the group reported.

While there are guidelines for screening and treating high blood pressure in adults, including addressing what’s called prehypertension, the researchers noted that not much is known about how young athletes fit into updated classifications for stages of hypertension. That became the focus of the study.

“The study highlights the importance of recognizing and addressing elevated blood pressure in young athletes. Despite being perceived as a generally healthy population, young athletes are not immune to heart disease, including elevated blood pressure. The findings emphasize that screening for hypertension should be a routine part of sports physicals and that confirmatory testing is needed to accurately diagnose the condition,” said lead author Dr. Aneeq Malik, an internal medicine physician at Olive View-UCLA Medical Center in Los Angeles and medical director of the Saving Hearts Foundation, quoted in the release.

For the study, researchers included 717 males, 477 females and two nonbinary athletes, whose ages ranged from 10 to 31 years old. The average age was 15. Blood pressure readings showed 21.3% met the definition of prehypertension, 13.2% had Stage I hyptertension and 8% had Stage II. Male participants had higher rates of Stage I and II (17.3% and 10.9%), compared to females (7.1% and 3.8%).

The highest rates of hypertension were found among young athletes who participated in multiple sports, at 28.3%, then among basketball players (27.6%) and football players (27.1%).

The researchers said that the “finding reveals a significant prevalence of elevated blood pressure measurements among young athletes at these heart screenings,” and added that “confirmatory testing in a controlled environment is crucial to ensure accurate diagnosis.”

Factors the researchers said could explain the findings in specific sports include:

  • Training routines unique to a sport.
  • Dietary habits for individual sports or positions within a sport.
  • Variations in average body size among sports.
  • Social determinants of health, which the Office of Disease Prevention and Health Promotion describes as “conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.”

The researchers said their findings align with other studies suggesting sports with more static — also called isometric — exercise are associated with higher blood pressure. That includes football and basketball, which include “moderate” levels of static exercise.

“Once hypertension is confirmed, educating young athletes and their families about the diagnosis becomes paramount. Appropriate lifestyle interventions, such as dietary adjustments and counseling on supplement use, increased physical activity, healthy sleep behavior and stress management, should be implemented along with routine monitoring,” Malik said.

If athletes are taught about the risks and provided support, they can take steps to stay healthy, he said.

Not related to sudden death

The study looks to future risk specifically linked to high blood pressure and should not be confused with high-profile news of young athletes collapsing because their heart suddenly stops beating, as happened to LeBron James’ son Bronny in 2023. His collapse resulted from a congenital heart condition that had not been detected prior to his cardiac arrest.

A Michigan Medicine article from the University of Michigan noted that “It’s important to recognize that athletes have about the same low risk of experiencing a sudden cardiac arrest as anyone else,” quoting Dr. David Bradley, a pediatric cardiologist at University of Michigan Health C.S. Mott Children’s Hospital.

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“When sudden cardiac arrest affects a well-known young athlete or a local teen in community it highlights the sudden and unexpected nature of this condition,” Bradley said.

He said that “the American Academy of Pediatrics recommends that all children be screened for conditions that can lead to cardiac arrest or death, regardless of their athletic status, especially as they enter middle school or high school.”

Bradley suggests that access to automated external defibrillators and knowledge of CPR are vital in case someone does collapse. But he emphasizes that risk for most young athletes is very low. writes that sudden cardiac arrest in young people can be caused by hypertrophic cardiomyopathy, coronary artery abnormalities, different arrhythmias, commotio cordis and other conditions.