Elite athletes may be in top physical shape, able to sprint, lift and play at the highest level of their sport, but a shock study shows they are at higher risk of deadly cardiovascular complications.
There have been a string of high-profile heart scares among top athletes, like Lebron James‘ basketball star son Bronny James at 18 years old and hall-of-famer Boston Celtics player Reggie Lewis.
Both suffered cardiac arrest while playing their sport, with the latter dying because of it at just 27 years old.
Events like this come as a shock as people wonder how premier athletes suffer a medical event associated with poor diet, obesity and a multitude of other poor comorbidities.
And in the wake of the Covid-19 pandemic, some believed vaccines may have played a role, while others say the virus itself may be to blame.
But now, scientists believe they’ve discovered a potential explanation behind why people in the best shape of their lives are suffering from cardiac conditions: hypertension, or high blood pressure.
Lebron James ‘ basketball star son Bronny James suffered cardiac arrest while playing basketball in 2023
Presenting findings at the American College of Cardiology’s Care of the Athletic Heart conference, a researcher from the University of Los Angeles Medical Center found nearly half of athletes suffered from elevated blood pressure – with multi-sport athletes and basketball players most at risk.
Among the general population in the US, approximately 47 percent of people have high blood pressure.
But athletes much younger than the average hypertension patient are still suffering from the condition.
Author of the abstract Dr Aneeq Malik, medical director of the Saving Hearts Foundation, said: ‘Despite being perceived as a generally healthy population, young athletes are not immune to heart disease, including elevated blood pressure.’
Researchers looked at 1,200 young athletes involved in a community-based athlete screening program in the Los Angeles area between the ages of 10 and 31 years old.
A majority of participants were men – 60 percent – and women comprised 40 percent.
Results showed 21 percent of athletes were classified as having prehypertension, 13 percent had stage one hypertension and eight percent were diagnosed with stage two hypertension.
The researchers attributed hypertension in athletes to training they undergo, such as certain cardio drills to improve endurance and speed or heavy weight lifting to build up key muscles used in games.
A difference in diets to maintain peak performance may also play a role, with different calorie, fat and protein ratios consumed by different players.
Hall-of-fame Boston Celtics basketball player Reggie Lewis suffered cardiac arrest while playing basketball in 1993, dying at just 27 years old
Additionally, the difference in physical size of athletes, such as extreme height in basketball players or heavier weight for certain football players, may also contribute.
In the case of hypertension, size matters because blood has farther to travel in people who are physically larger, increasing how hard the heart works.
Blood pressure is measured in two numbers in millimeters of mercury (mm Hg). The first number represents the pressure caused by the heart beating and pushing blood through arteries and the second is pressure in arteries as the heart relaxes between beats.
A healthy blood pressure for most adults is 90 to 120/60 to 80 mm Hg.
Prehypertension is 120 to 129/less than 80. Stage one is 130 to 139/80 to 89 mm Hg and stage two is more than 140/more than 90.
When someone has blood pressure higher than 120/80 mmHg their heart is in ‘overdrive,’ according to the American College of Cardiology. This forces the organ to work harder to pump blood throughout the body.
Over time, high blood pressure can weaken the heart and blood vessels, which can cause cardiovascular disease, including sudden cardiac arrest.
Male athletes in the study were more likely than female ones to have stage one or two hypertension, and athletes who participated in multiple sports had the highest prevalence, at about one-quarter.
Basketball players and football players were nearly tied for second highest occurrence at about one-in-four.
Based on the findings, Dr Malik said: ‘The study highlights the importance of recognizing and addressing elevated blood pressure in young athletes… 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.’
This study confirmed previous findings that showed sports with higher levels of static exercise – that which increases tension in muscles – were associated with higher blood pressure.
Both basketball and football involve moderate levels of this type of physical activity.
A 2016 study published in a cardiovascular journal found sudden cardiac death is the most common cause of sudden death in athletes. While rates vary widely, one estimate puts the incidence rate of sudden cardiac death in this population from one in 40,000 to one in 80,000 per year.
Additionally, Dr Muhammad Aftab, a heart surgeon who has researched the matter separately, estimates sudden cardiac arrest is responsible for 75 percent of fatalities during sports of exercise.
To avoid potentially fatal hypertensive events, Dr Malik said it is important to educate young athletes and their families on the condition and what lifestyle modifications they can make to reduce their risk, including dietary changes, healthy sleep habits, managing stress and certain supplement use.