Arterial hypertension, physical exercise, and sport

Abstract:

Arterial hypertension is the most frequent disease in recreationally physically active persons. Lifestyle changes, nutrition and physical exercise have an important role in its prevention and treatment. Regular dynamic aerobic training of low and moderate intensity level (40-60% of individual VO2max) lowers systolic and diastolic pressure in normotensive and hypertensive persons. The basic mechanism of physical activity is based on the reduction of total peripheral vascular resistance. In hypertensive persons, the estimation of inclusion in the activity and the intensity of activity depend on the degree of hypertension, the possible existing complications of the disease and the presence and severity of the comorbidities. Clinical evaluation depends on intensity of the exercise, symptoms, clinical findings, risk factors and overall cardiovascular risk. Before engaging in physical activity, special attention and evaluation has to be directed to persons with low cardiovascular capability and concomitant chronic diseases, coronary heart disease, diabetes and cardiometabolic syndrome. Compulsory clinical and laboratory diagnostics of athletes with arterial hypertension are wider than in the general population. Antihypertensives drugs of choice are: Ca++ channel inhibitors, ACE inhibitors, and AT II receptor inhibitors. Due to their impact on sports performance and ability, effect on the level of serum electrolytes and the fact that they are considered as doping in some sports, β-adrenergic receptor blockers and diuretics are recommended only when the first group of antihypertensives proves inefficient.

Key words:
arterial hypertension; exercise impact; physical exercise; prevention; sports