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Наблюдение за подростками с повышенным артериальным давлением, занимающимися спортом
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Balykova L.A., Ivianskii S.A., Shirokova A.A. et al. Observation of adolescents with high blood pressure, involved in physical activity. Cardiosomatics. 2017; 8 (2): 16–19.
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Ключевые слова: юные спортсмены, «спортивное сердце», артериальная гипертензия.
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The article provides a brief overview of the literature data on the prevalence and causes of hypertension in athletes. Different points of view on the effect of regular physical exertion on the level of arterial pressure are considered. In addition, the available diagnostic approaches to the detection of high blood pressure are described. Based on the available data, domestic and foreign experience, oftimal algorithms for diagnosing arterial hypertension in young people involved in sports are presented.
Key words: young athletes, "sports heart", arterial hypertension.
2. Ostchega Y, Carroll M, Prineas RJ et al. Trends of Elevated Blood Pressure Among Children and Adolescents: Data From the National Health and Nutrition Examination Survey 1988–2006. Am J Hypertens 2009; 22: 59–67.
3. Parker ED, Schmitz KH, Jacobs DR Jr et al. Physical activity in young adults and incident hypertension over 15 years of follow-up: the CARDIA Study. Am J Public Health 2007; 97: 703–9.
4. Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol 2006; 33: 853–6.
5. Bauman AE et al. Correlates of physical activity in youth: a review of quantitative systematic reviews. Int Rev Sport Exercise Psychol 2011; 4: 29–41.
6. Социальные детерминанты здоровья и благополучия подростков. Исследование «Поведение детей школьного возраста в отношении здоровья»: международный отчет по результатам обследования 2009–2010 гг. Под ред. С.Currie и др. Копенгаген: Европейское региональное бюро ВОЗ, 2012. Серия: Политика охраны здоровья детей и подростков, вып. №6. / Sotsial'nye determinanty zdorov'ia i blagopoluchiia podrostkov. Issledovanie «Povedenie detei shkol'nogo vozrasta v otnoshenii zdorov'ia»: mezhdunarodnyi otchet po rezul'tatam obsledovaniia 2009–2010 gg. Pod red. C.Currie i dr. Kopengagen: Evropeiskoe regional'noe biuro VOZ, 2012. Seriia: Politika okhrany zdorov'ia detei i podrostkov, vyp. №6. [in Russian]
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8. Mottram PM, Haluska B, Yuda S et al. Patients with a hypertensive response to exercise have impaired systolic function without diastolic dysfunction or left ventricular hypertrophy. J Am Coll Cardiol 2004; 43: 848–53.
9. Kjeldsen SE, Mundal R, Sandvik L et al. Supine and exercise systolic blood pressure predict cardiovascular death in middle-aged men. J Hypertens 2001; 19: 1343–8.
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11. Leyk D, Rither I, Wunderlich M et al. Utilization and Implementation of Sports Medical Screening Examinations: Survey of More Than 10000 Long-Distance Runners. Dtsch Arztebl Int 2008; 105 (36): 609–14.
12. Miyachi M, Kawano H, Sugawara J. Unfavorable effects of resistance training on central arterial compliance: a randomized inter-vention study. Circulation 2004; 110: 2858–63.
13. O'Farrell AM, Allwright SP, Kenny SC. Alcohol use among amateur sportsmen in Ireland. BMC Re-searcn Notes 2010; 3: 313.
14. Cregler LL. Substance abuse in sports the impact of cocaine, alcohol, steroids, and other drugs on the heart. In: Williams R, editor. The Athlete and Heart Disease. Diagnosis, Evaluation and Management. Philadelphia, PA: Lippincott Williams & Wilkins, 1998; p. 131–54.
15. Kloner RA. Illicit drug use in the athlete as a contributor to cardiac events. In: Estes III NAM, Salem D, Wang P, editors. Sudden Cardiac Death in the Athlete. Armonk, NY: Futura Pub. Co. 1998; p. 441–52.
16. Samenuk D, Link MS, Homoud MK et al. Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Mayo Clin Proc 2002; 77: 12–6.
17. Iglesim Cubera G. Left ventricular mass index and sports: the influence of different Sports activities and arterial blood pressure. Int J Cardiol 2000; 75: 261–5.
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19. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975; 82: 521–4.
20. MacDougall JD, Tuxen D, Sale DG et al. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol 1985; 58: 785–90.
21. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart. A metaanalysis of cardiac structure and function. Circulation 2000; 101: 336–44.
22. Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the 'Morganroth hypothesis'. Sports Med 2008; 38 (1): 69–90.
23. Carbuhn AF, Womack JW, Green JS et al. Performance and blood pressure characteristics of first-year national collegiate athletic association division I football players. J Strength Cond Res 2008; 22 (4): 1347–54.
24. Selden MA, Helzberg JH, Waeckerle JF et al. Cardiometabolic abnormalities in current National Football League players. Am J Cardiol 2009; 103 (7): 969–71.
25. Helzberg JH, Waeckerle JF, Camilo J et al. Comparison of cardiovascular and metabolic risk factors in professional baseball players versus professional football players. Am J Cardiol 2010; 106 (5): 664–7.
26. Weiner RB, Wang F, Isaacs SK et al. Blood Pressure and Left Ventricular Hypertrophy During American-Style Football Participation. Circulation 2013; 128: 524–31.
27. Whelton PK, Appel LJ, Sacco RL et al. Sodium, bloodpressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012; 126: 2880–9.
28. Sacks FM, Svetkey LP, Vollmer WM et al; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet: DASH-Sodium Collaborative Research Group. N Eng J Med 2001; 344: 3–10.
29. Mahmud A, Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens 2003; 16: 229–32.
30. Missault L, Duprez D, de Buyzere M et al. Decreased exercise capacity in mild essential hypertension: non-invasive indicators of limiting factors. J Hum Hypertens 1992; 6: 151–5.
31. Рекомендации по диагностике, лечению и профилактике артериальной гипертензии у детей и подростков. Всероссийское научное общество кардиологов, Ассоциация детских кардиологов России. 2005. www.cardiosite.ru / Rekomendatsii po diagnostike, lecheniiu i profilaktike arterial'noi gipertenzii u detei i podrostkov. Vserossiiskoe nauchnoe obshchestvo kardiologov, Assotsiatsiia detskikh kardiologov Rossii. 2005. www.cardiosite.ru [in Russian]
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1. Nakashima M, Miura K, Kido T et al. Exercise blood pressure in young adults as a predictor of future blood pressure: a 12-year follow-up of medical school graduates. J Hum Hypertens 2004; 18: 815–21.
2. Ostchega Y, Carroll M, Prineas RJ et al. Trends of Elevated Blood Pressure Among Children and Adolescents: Data From the National Health and Nutrition Examination Survey 1988–2006. Am J Hypertens 2009; 22: 59–67.
3. Parker ED, Schmitz KH, Jacobs DR Jr et al. Physical activity in young adults and incident hypertension over 15 years of follow-up: the CARDIA Study. Am J Public Health 2007; 97: 703–9.
4. Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol 2006; 33: 853–6.
5. Bauman AE et al. Correlates of physical activity in youth: a review of quantitative systematic reviews. Int Rev Sport Exercise Psychol 2011; 4: 29–41.
6. Sotsial'nye determinanty zdorov'ia i blagopoluchiia podrostkov. Issledovanie «Povedenie detei shkol'nogo vozrasta v otnoshenii zdorov'ia»: mezhdunarodnyi otchet po rezul'tatam obsledovaniia 2009–2010 gg. Pod red. C.Currie i dr. Kopengagen: Evropeiskoe regional'noe biuro VOZ, 2012. Seriia: Politika okhrany zdorov'ia detei i podrostkov, vyp. №6. [in Russian]
7. Corrado D, Pelliccia A, Bjornstad HH et al. Thiene for the study group of Sport cardiology of the working group of cardiac rehabilitation And exercise physiology and the working group of Myocardial and pericardial diseases of the european society Of cardiology.et al. Cardiovascular preparticipation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 516–24.
8. Mottram PM, Haluska B, Yuda S et al. Patients with a hypertensive response to exercise have impaired systolic function without diastolic dysfunction or left ventricular hypertrophy. J Am Coll Cardiol 2004; 43: 848–53.
9. Kjeldsen SE, Mundal R, Sandvik L et al. Supine and exercise systolic blood pressure predict cardiovascular death in middle-aged men. J Hypertens 2001; 19: 1343–8.
10. Rasprostranennost' arterial'noi gipertenzii u sportsmenov. M.: Moskovskii nauchno-prakticheskii tsentr sportivnoi meditsiny, 2009. http://www.bmsi.ru/doc/2a0c99a2-4b53-4f48-8220-67438b1e3091 [in Russian]
11. Leyk D, Rither I, Wunderlich M et al. Utilization and Implementation of Sports Medical Screening Examinations: Survey of More Than 10000 Long-Distance Runners. Dtsch Arztebl Int 2008; 105 (36): 609–14.
12. Miyachi M, Kawano H, Sugawara J. Unfavorable effects of resistance training on central arterial compliance: a randomized inter-vention study. Circulation 2004; 110: 2858–63.
13. O'Farrell AM, Allwright SP, Kenny SC. Alcohol use among amateur sportsmen in Ireland. BMC Re-searcn Notes 2010; 3: 313.
14. Cregler LL. Substance abuse in sports the impact of cocaine, alcohol, steroids, and other drugs on the heart. In: Williams R, editor. The Athlete and Heart Disease. Diagnosis, Evaluation and Management. Philadelphia, PA: Lippincott Williams & Wilkins, 1998; p. 131–54.
15. Kloner RA. Illicit drug use in the athlete as a contributor to cardiac events. In: Estes III NAM, Salem D, Wang P, editors. Sudden Cardiac Death in the Athlete. Armonk, NY: Futura Pub. Co. 1998; p. 441–52.
16. Samenuk D, Link MS, Homoud MK et al. Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Mayo Clin Proc 2002; 77: 12–6.
17. Iglesim Cubera G. Left ventricular mass index and sports: the influence of different Sports activities and arterial blood pressure. Int J Cardiol 2000; 75: 261–5.
18. Smolenskii A.V., Zolicheva S.Iu., Mikhailova A.V. i dr. Morfofunktsional'nye otlichiia iunykh grebtsov s povyshennym urovnem arterial'nogo davleniia. Fiziologiia cheloveka. 2010; 4: 15–9. [in Russian]
19. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975; 82: 521–4.
20. MacDougall JD, Tuxen D, Sale DG et al. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol 1985; 58: 785–90.
21. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart. A metaanalysis of cardiac structure and function. Circulation 2000; 101: 336–44.
22. Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the 'Morganroth hypothesis'. Sports Med 2008; 38 (1): 69–90.
23. Carbuhn AF, Womack JW, Green JS et al. Performance and blood pressure characteristics of first-year national collegiate athletic association division I football players. J Strength Cond Res 2008; 22 (4): 1347–54.
24. Selden MA, Helzberg JH, Waeckerle JF et al. Cardiometabolic abnormalities in current National Football League players. Am J Cardiol 2009; 103 (7): 969–71.
25. Helzberg JH, Waeckerle JF, Camilo J et al. Comparison of cardiovascular and metabolic risk factors in professional baseball players versus professional football players. Am J Cardiol 2010; 106 (5): 664–7.
26. Weiner RB, Wang F, Isaacs SK et al. Blood Pressure and Left Ventricular Hypertrophy During American-Style Football Participation. Circulation 2013; 128: 524–31.
27. Whelton PK, Appel LJ, Sacco RL et al. Sodium, bloodpressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012; 126: 2880–9.
28. Sacks FM, Svetkey LP, Vollmer WM et al; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet: DASH-Sodium Collaborative Research Group. N Eng J Med 2001; 344: 3–10.
29. Mahmud A, Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens 2003; 16: 229–32.
30. Missault L, Duprez D, de Buyzere M et al. Decreased exercise capacity in mild essential hypertension: non-invasive indicators of limiting factors. J Hum Hypertens 1992; 6: 151–5.
31. Rekomendatsii po diagnostike, lecheniiu i profilaktike arterial'noi gipertenzii u detei i podrostkov. Vserossiiskoe nauchnoe obshchestvo kardiologov, Assotsiatsiia detskikh kardiologov Rossii. 2005. www.cardiosite.ru [in Russian]
32. Makarov L.M., Fedina N.N., Komoliatova V.N. i dr. Normativnye parametry arterial'nogo davleniia u iunykh elitnykh sportsmenov pri probe s dozirovannoi fizicheskoi nagruzkoi. Sbornik tezisov 15-go Kongressa Rossiiskogo obshchestva kholterovskogo monitorirovaniia i neinvazivnoi elektrofiziologii (ROKhMiNE), 7-go Vserossiiskogo kongressa «Klinicheskaia elektrokardiologiia», 23–24 aprelia 2014, Belgorod. M.: Dizart Tim, 2014; s. 49. [in Russian]
33. Deev V.V., Badtieva V.A., Pavlov V.I., Ordzhonikidze Z.G. O kriteriiakh gipertenzii v sporte. Sbornik tezisov 15-go Kongressa Rossiiskogo obshchestva kholterovskogo monitorirovaniia i neinvazivnoi elektrofiziologii (ROKhMiNE), 7-go Vserossiiskogo kongressa «Klinicheskaia elektrokardiologiia», 23–24 aprelia 2014, Belgorod. M.: Dizart Tim, 2014; s. 49–50. [in Russian]
34. Balykova L.A., Ivianskii S.A., Shirokova A.A. i dr. Otsenka urovnia arterial'nogo davleniia u detei, privlechennykh k reguliarnym zaniatiiam sportom. Pediatriia im. N.G.Speranskogo. 2015; 94 (6): 48–54. [in Russian]
35. Sportivnaia meditsina: natsional'noe rukovodstvo. Pod red. S.P.Mironova, B.A.Poliaeva, G.A.Makarovoi. 2012. [in Russian]
1 ФГБОУ ВО «Национальный исследовательский Мордовский государственный университет им. Н.П.Огарева». 430005, Россия, Саранск, ул. Большевистская, д. 68;
2 ГБУЗ РМ «Детская республиканская клиническая больница». 430032, Россия, Саранск, ул. Розы Люксембург, д. 15
*larisabalykova@yandex.ru
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L.A.Balykova*1, S.A.Ivianskiy1, A.A.Shirokova1, N.V.Shchekina2, K.A.Varlashina1
1 N.P.Ogarev National Research Mordovia State University. 430005, Russian Federation, Saransk, ul. Bol'shevistskaia, d. 68;
2 Children Republican Clinical Hospital. 430032, Russian Federation, Saransk, ul. Rozy Liuksemburg, d. 15
*larisabalykova@yandex.ru