Skip to main content
SpringerLink
Log in

Recommendations for exercise and screening for safe athletic participation in hypertensive youth

  • Review
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Physical activity is an important component of ideal cardiovascular health. Current guidelines recommend that youth with hypertension participate in competitive sports once hypertensive target organ effects and risks have been assessed and that children with hypertension receive treatment to lower BP below stage 2 thresholds (e.g., < 140/90 mmHg or < 95th percentile + 12 mmHg) before participating in competitive sports. Despite these recommendations, pediatricians and pediatric subspecialists continue to struggle with how best to counsel their patients regarding appropriate forms of physical activity, the impact of exercise on blood pressure, and how best to screen for cardiovascular conditions that place youth at risk for sudden cardiac death. This review provides a summary of our current knowledge regarding the safety and utility of exercise in the management of high blood pressure in youth. We review determinants of blood pressure during exercise, the impact of blood pressure on cardiovascular health and structure, mechanisms for assessing cardiometabolic fitness (e.g., exercise stress test), contraindications to athletic participation, and how best to plan for athletic participation among hypertensive youth. Greater knowledge in these areas may offer clarity to providers faced with the challenge of prescribing exercise recommendations for hypertensive youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, Urbina E, Van Horn LV, Zachariah JP, American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; and Stroke Council (2016) Cardiovascular health promotion in children: challenges and opportunities for 2020 and beyond: a scientific statement from the American Heart Association. Circulation. 134(12):e236–e255

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sharma AK, Metzger DL, Rodd CJ (2018) Prevalence and severity of high blood pressure among children based on the 2017 American Academy of Pediatrics Guidelines. JAMA Pediatr 172(6):557–565

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lively MW (1999) Preparticipation physical examinations: a collegiate experience. Clin J Sport Med 9(1):3–8

    Article  CAS  PubMed  Google Scholar 

  4. Stiefel EC, Field L, Replogle W, McIntyre L, Igboechi O, Savoie FH 3rd. (2016) The prevalence of obesity and elevated blood pressure in adolescent student athletes from the state of Mississippi. Orthop J Sports Med 4(2):2325967116629368

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wright CJ, Abbey EL, Brandon BA, Reisman EJ, Kirkpatrick CM (2017 Sep) Cardiovascular disease risk profile of NCAA Division III intercollegiate football athletes: a pilot study. Phys Sportsmed 45(3):280–285

    Article  PubMed  Google Scholar 

  6. Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM, Subcommittee On Screening And Management of High Blood Pressure in Children (2017) Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140(3). pii: e20171904. https://doi.org/10.1542/peds.2017-1904

  7. Mirabelli MH, Devine MJ, Singh J, Mendoza M et al (2015) Am Fam Physician 92(5):371–376

    PubMed  Google Scholar 

  8. Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, Dimeff R, Douglas PS, Glover DW, Hutter AM Jr, Krauss MD, Maron MS, Mitten MJ, Roberts WO, Puffer JC, American Heart Association Council on Nutrition, Physical Activity,and Metabolism (2007) Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 115(12):1643–1455

    Article  PubMed  Google Scholar 

  9. Caspersen CJ, Powell KE, Christenson GM (1985) Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 100(2):126–131

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2017) Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 135(10):e146–e603

    Article  PubMed  PubMed Central  Google Scholar 

  11. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute (2011) Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 128(Suppl 5):S213–S256

    PubMed Central  Google Scholar 

  12. Zhu Z, Tang Y, Zhuang J, Liu Y, Wu X, Cai Y, Wang L, Cao ZB, Chen P (2019) Physical activity, screen viewing time, and overweight/obesity among Chinese children and adolescents: an update from the 2017 physical activity and fitness in China-the youth study. BMC Public Health 19(1):197

    Article  PubMed  PubMed Central  Google Scholar 

  13. Jetté M, Sidney K, Blümchen G (1990) Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol 13(8):555–565

    Article  PubMed  Google Scholar 

  14. Bouchard C, Godin G, Landry F, Shephard R, Skinner J (1983) Multiples of the resting metabolic rate (METS) of physical activities. Report submitted to Canada Fitness Survey. Ottawa

  15. de Moraes AC, Carvalho HB, Siani A, Barba G, Veidebaum T, Tornaritis M, Molnar D, Ahrens W, Wirsik N, De Henauw S, Mårild S, Lissner L, Konstabel K, Pitsiladis Y, Moreno LA, IDEFICS consortium (2015) Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: high blood pressure, lifestyle and children. Int J Cardiol 180:165–170

    Article  PubMed  Google Scholar 

  16. Seals DR, Washburn RA, Hanson PG, Painter PL, Nagle FJ (1983) Increased cardiovascular response to static contraction of larger muscle groups. J Appl Physiol Respir Environ Exerc Physiol 54(2):434–437

    CAS  PubMed  Google Scholar 

  17. Farpour-Lambert NJ, Aggoun Y, Marchand LM, Martin XE, Herrmann FR, Beghetti M (2009) Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children. J Am Coll Cardiol 54(25):2396–2406

    Article  CAS  PubMed  Google Scholar 

  18. Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR, Kimball TR, Knilans TK, Nixon PA, Rhodes J, Yetman AT, American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth (2006) Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation 113(15):1905–1920

    Article  PubMed  Google Scholar 

  19. Braden DS, Strong WB (1990) Cardiovascular responses to exercise in childhood. Am J Dis Child 144(11):1255–1260

    CAS  PubMed  Google Scholar 

  20. Mitchell JH, Payne FC, Saltin B, Schibye B (1980) The role of muscle mass in the cardiovascular response to static contractions. J Physiol 309:45–54

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Mitchell JH, Schibye B, Payne FC 3rd, Saltin B (1981) Response of arterial blood pressure to static exercise in relation to muscle mass, force development, and electromyographic activity. Circ Res 48(6 Pt 2):I70–I75

    CAS  PubMed  Google Scholar 

  22. Chiolero A, Cachat F, Burnier M, Paccaud F, Bovet P (2007) Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. J Hypertens 25(11):2209–2217

    Article  CAS  PubMed  Google Scholar 

  23. Daniels SR, Kimball TR, Khoury P, Witt S, Morrison JA (1996) Correlates of the hemodynamic determinants of blood pressure. Hypertension. 28(1):37–41

    Article  CAS  PubMed  Google Scholar 

  24. Ashton RE, Tew GA, Aning JJ, Gilbert SE, Lewis L, Saxton JM (2018) Effects of short-term, medium-term and long-term resistance exercise training on cardiometabolic health outcomes in adults: systematic review with meta-analysis. Br J Sports Med (22)

  25. Mundal R, Kjeldsen SE, Sandvik L, Erikssen G, Thaulow E, Erikssen J (1996) Exercise blood pressure predicts mortality from myocardial infarction. Hypertension 27:324–329

    Article  CAS  PubMed  Google Scholar 

  26. Le VV, Mitiku T, Sungar G, Myers J, Froelicher V (2008) The blood pressure response to dynamic exercise testing: a systematic review. Prog Cardiovasc Dis 51(2):135–160

    Article  PubMed  Google Scholar 

  27. Gaudreault V, Després JP, Rhéaume C, Alméras N, Bergeron J, Tremblay A, Poirier P (2013) Exercise-induced hypertension in men with metabolic syndrome: anthropometric, metabolic, and hemodynamic features. Metab Syndr Relat Disord 11(1):7–14

    Article  CAS  PubMed  Google Scholar 

  28. Skretteberg PT, Grundvold I, Kjeldsen SE, Engeseth K, Liestøl K, Erikssen G, Erikssen J, Gjesdal K, Bodegard J (2013) Seven-year increase in exercise systolic blood pressure at moderate workload predicts long-term risk of coronary heart disease and mortality in healthy middle-aged men. Hypertension. 61(5):1134–1140

    Article  CAS  PubMed  Google Scholar 

  29. Lima SG, Albuquerque MF, Oliveira JR, Ayres CF, Cunha JE, Oliveira DF, Lemos RR, Souza MB, Barbosa e Silva O (2013) Exaggerated blood pressure response during the exercise treadmill test as a risk factor for hypertension. Braz J Med Biol Res 46(4):368–347

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Yzaguirre I, Grazioli G, Domenech M, Vinuesa A, Pi R, Gutierrez J, Coca A, Brugada J, Sitges M (2017) Exaggerated blood pressure response to exercise and late-onset hypertension in young adults. Blood Press Monit 22(6):339–344

    Article  PubMed  Google Scholar 

  31. Grøntved A, Brage S, Møller NC, Kristensen PL, Wedderkopp N, Froberg K, Andersen LB (2011) Hemodynamic variables during exercise in childhood and resting systolic blood pressure levels 6 years later in adolescence: the European Youth Heart Study. J Hum Hypertens 25(10):608–614

    Article  PubMed  Google Scholar 

  32. Nudel DB, Gootman N, Brunson SC, Stenzler A, Shenker IR, Gauthier BG (1980) Exercise performance of hypertensive adolescents. Pediatrics. 65(6):1073–1078

    CAS  PubMed  Google Scholar 

  33. Hacke C, Weisser B (2016) Reference values for exercise systolic blood pressure in 12- to 17-year-old adolescents. Am J Hypertens 29(6):747–753

    Article  PubMed  Google Scholar 

  34. Stergiou GS, Alamara CV, Salgami EV, Vaindirlis IN, Dacou-Voutetakis C, Mountokalakis TD (2005) Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Press Monit 10(3):143–147

    Article  PubMed  Google Scholar 

  35. Li Z, Snieder H, Harshfield GA, Treiber FA, Wang X (2009) A 15-year longitudinal study on ambulatory blood pressure tracking from childhood to early adulthood. Hypertens Res 32(5):404–410

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kouidi E, Fahadidou-Tsiligiroglou A, Tassoulas E, Deligiannis A, Coats A (1999) White coat hypertension detected during screening of male adolescent athletes. Am J Hypertens 12(2 Pt 1):223–226

    Article  CAS  PubMed  Google Scholar 

  37. Trachsel LD, Carlen F, Brugger N, Seiler C, Wilhelm M (2015) Masked hypertension and cardiac remodeling in middle-aged endurance athletes. J Hypertens 33(6):1276–1283

    Article  CAS  PubMed  Google Scholar 

  38. Bjelakovic B, Jaddoe VW, Vukomanovic V et al (2015) The relationship between currently recommended ambulatory systolic blood pressure measures and left ventricular mass index in pediatric hypertension. Curr Hypertens Rep 17(4):534

    Article  PubMed  Google Scholar 

  39. Daimee UA, Lande MB, Tang W, Tu XM, Veazie P, Bisognano JD, Block R, Teeters JC (2017) Blood pressure and left ventricular mass index in healthy adolescents. Blood Press Monit 22(1):48–50

    Article  PubMed  Google Scholar 

  40. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566

    Article  CAS  PubMed  Google Scholar 

  41. Drazner MH, Rame JE, Marino EK, Gottdiener JS, Kitzman DW, Gardin JM, Manolio TA, Dries DL, Siscovick DS (2004) Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. J Am Coll Cardiol 43:2207–2215

    Article  PubMed  Google Scholar 

  42. Jing L, Nevius CD, Friday CM, Suever JD, Pulenthiran A, Mejia-Spiegeler A, Kirchner HL, Cochran WJ, Wehner GJ, Chishti AS, Haggerty CM, Fornwalt BK (2017) Ambulatory systolic blood pressure and obesity are independently associated with left ventricular hypertrophic remodeling in children. J Cardiovasc Magn Reson 19(1):86

    Article  PubMed  PubMed Central  Google Scholar 

  43. Jing L, Binkley CM, Suever JD, Umasankar N, Haggerty CM, Rich J, Wehner GJ, Hamlet SM, Powell DK, Radulescu A, Kirchner HL, Epstein FH, Fornwalt BK (2016) Cardiac remodeling and dysfunction in childhood obesity: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 18:28

    Article  PubMed  PubMed Central  Google Scholar 

  44. Dhuper S, Abdullah RA, Weichbrod L, Mahdi E, Cohen HW (2011) Association of obesity and hypertension with left ventricular geometry and function in children and adolescents. Obesity (Silver Spring) 19:128–133

    Article  Google Scholar 

  45. Pelliccia A, Maron BJ, Culasso F, Spataro A, Caselli G (1996) Athlete’s heart in women. Echocardiographic characterization of highly trained elite female athletes. JAMA. 276(3):211–215

    Article  CAS  PubMed  Google Scholar 

  46. Morganroth J, Maron BJ, Henry WL, Epstein SE (1975) Comparative left ventricular dimensions in trained athletes. Ann Intern Med 82(4):521–524

    Article  CAS  PubMed  Google Scholar 

  47. Sharma S, Maron BJ, Whyte G, Firoozi S, Elliott PM, McKenna WJ (2002) Physiologic limits of left ventricular hypertrophy in elite junior athletes: relevance to differential diagnosis of athlete's heart and hypertrophic cardiomyopathy. J Am Coll Cardiol 40(8):1431–1436

    Article  PubMed  Google Scholar 

  48. Utomi V, Oxborough D, Whyte GP et al (2013) Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. Heart 99:1727–1733

    Article  PubMed  Google Scholar 

  49. Caselli S, Maron MS, Urbano-Moral JA, Pandian NG, Maron BJ, Pelliccia A (2014) Differentiating left ventricular hypertrophy in athletes from that in patients with hypertrophic cardiomyopathy. Am J Cardiol 114(9):1383–1389

    Article  PubMed  Google Scholar 

  50. Lin J, Wang F, Weiner RB, JR DL, Wasfy MM, Berkstresser B, Lewis GD, Hutter AM Jr, Picard MH, Baggish AL (2016) Blood pressure and LV remodeling among american-style football players. JACC Cardiovasc Imaging 9(12):1367–1376

    Article  PubMed  PubMed Central  Google Scholar 

  51. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO (2009) Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 119(8):1085–1092

    Article  PubMed  Google Scholar 

  52. Link MS, Estes NA 3rd, Maron BJ, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 13: commotio cordis: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e339–e342

    PubMed  Google Scholar 

  53. Braverman AC, Harris KM, Kovacs RJ, Maron BJ, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 7: aortic diseases, including marfan syndrome: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e303–e309

    Article  PubMed  Google Scholar 

  54. Bonow RO, Nishimura RA, Thompson PD, Udelson JE, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 5: valvular heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e292–e297

    Article  PubMed  Google Scholar 

  55. Maron BJ, Udelson JE, Bonow RO, Nishimura RA, Ackerman MJ, Estes NA 3rd, Cooper LT Jr, Link MS, Maron MS, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e273–e280

    PubMed  Google Scholar 

  56. Pelliccia A, Adami PE, Quattrini F, Squeo MR, Caselli S, Verdile L, Maestrini V, Di Paolo F, Pisicchio C, Ciardo R, Spataro A (2017) Are Olympic athletes free from cardiovascular diseases? Systematic investigation in 2352 participants from Athens 2004 to Sochi 2014. Br J Sports Med 51(4):238–243

    Article  PubMed  Google Scholar 

  57. Landry CH, Allan KS, Connelly KA, Cunningham K, Morrison LJ, Dorian P, Rescu investigators (2017) Sudden cardiac arrest during participation in competitive sports. N Engl J Med 377(20):1943–1953

    Article  PubMed  PubMed Central  Google Scholar 

  58. Van Hare GF, Ackerman MJ, Evangelista JA, Kovacs RJ, Myerburg RJ, Shafer KM, Warnes CA, Washington RL, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e281–e291

    PubMed  Google Scholar 

  59. Zipes DP, Link MS, Ackerman MJ, Kovacs RJ, Myerburg RJ, Estes NA 3rd, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 9: arrhythmias and conduction defects: a scientific statement from the American Heart Association and American College of Cardiology. Circulation 132(22):e315–e325

    Article  PubMed  Google Scholar 

  60. Ackerman MJ, Zipes DP, Kovacs RJ, Maron BJ (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 10: the cardiac channelopathies: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol 66(21):2424–2428

    Article  PubMed  Google Scholar 

  61. Thompson PD, Myerburg RJ, Levine BD, Udelson JE, Kovacs RJ, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 8: coronary artery disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 132(22):e310–e314

    Article  PubMed  Google Scholar 

  62. Norrish G, Cantarutti N, Pissaridou E, Ridout DA, Limongelli G, Elliott PM, Kaski JP (2017) Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: a systematic review and meta-analysis. Eur J Prev Cardiol 24(11):1220–1230

    Article  PubMed  Google Scholar 

  63. Baker-Smith CM, Vashist S (2012) Cardiac arrest and sudden death in the pediatric population. J Clin Exp Cardiol 3:7

    Article  Google Scholar 

  64. Maron BJ (1998) Cardiovascular risks to young persons on the athletic field. Ann Intern Med 129(5):379–386

    Article  CAS  PubMed  Google Scholar 

  65. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 114(2 Suppl 4th Report):555–576

    Article  Google Scholar 

  66. Campbell RM, Douglas PS, Eidem BW, Lai WW, Lopez L, Sachdeva R (2014) ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/SCMR/SOPE 2014 appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 64(19):2039–2060

    Article  PubMed  Google Scholar 

  67. Rice SG, American Academy of Pediatrics Council on sports medicine and fitness (2008) Medical conditions affecting sports participation. Pediatrics. 121(4):841–848

    Article  PubMed  Google Scholar 

  68. McCambridge TM, Benjamin HJ, Brenner JS, Cappetta CT, Demorest RA, Gregory AJ, Halstead M, Koutures CG, LaBella CR, Martin S, Rice SG, Council on Sports Medicine and Fitness (2010) Athletic participation by children and adolescents who have systemic hypertension. Pediatrics. 125(6):1287–1294

    Article  PubMed  Google Scholar 

  69. Black HR, Sica D, Ferdinand K, White WB, American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 6: hypertension: a scientific statement from the American Heart Association and the American College of Cardiology. Circulation. 132(22):e298–e302

    Article  PubMed  Google Scholar 

  70. Maron BJ, Friedman RA, Kligfield P, Levine BD, Viskin S, Chaitman BR, Okin PM, Saul JP, Salberg L, Van Hare GF, Soliman EZ, Chen J, Matherne GP, Bolling SF, Mitten MJ, Caplan A, Balady GJ, Thompson PD, American Heart Association Council on Clinical Cardiology; Advocacy Coordinating Committee; Council on Cardiovascular Disease in the Young; Council on Cardiovascular Surgery and Anesthesia; Council on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; Council on Quality of Care and Outcomes Research, and American College of Cardiology (2014) Assessment of the 12-lead electrocardiogram as a screening test for detection of cardiovascular disease in healthy general populations of young people (12–25 years of age): a scientific statement from the American Heart Association and the American College of Cardiology. J Am Coll Cardiol 64(14):1479–1514

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Carissa M. Baker-Smith & Nicholas Pietris

  2. Department of Pediatrics, Valley Children’s Medical Center, Madera, CA, USA

    Laide Jinadu

Authors
  1. Carissa M. Baker-Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicholas Pietris
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laide Jinadu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carissa M. Baker-Smith.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Answers: 1d 2a 3d 4b 5c

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baker-Smith, C.M., Pietris, N. & Jinadu, L. Recommendations for exercise and screening for safe athletic participation in hypertensive youth. Pediatr Nephrol 35, 743–752 (2020). https://doi.org/10.1007/s00467-019-04258-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-019-04258-y

Keywords

Search

Navigation