Blood pressure characteristics of collegiate female athletes: A call for more focused attention on young women's health

Yasmeen K Taha; Cecil A Rambarat; Fred Reifsteck; Robert Hamburger; James R Clugston; Eileen M Handberg; Joan M Street; Breton Asken; Osama Dasa; Matthew Kelling; Michelle Dimza; Carl J Pepine; Matthew W Martinez; Katherine M Edenfield

doi:10.1016/j.ahjo.2022.100085

Blood pressure characteristics of collegiate female athletes: A call for more focused attention on young women's health

Am Heart J Plus. 2022 Jan 17:13:100085. doi: 10.1016/j.ahjo.2022.100085. eCollection 2022 Jan.

Affiliations

¹ Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.
² Student Health Center, University of Georgia, Athens, GA, USA.
³ Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.
⁴ Student Health Care Center, University of Florida, Gainesville, FL, USA.
⁵ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁶ Division of General Internal Medicine, University of Florida, Gainesville, FL, USA.
⁷ Morristown Medical Center, Atlantic Health System, Morristown, NJ, USA.

Abstract

Background: There is a paucity of data describing the association between blood pressure (BP) and cardiac remodeling in female collegiate athletes.

Methods: This retrospective cohort review describes the BP characteristics and echocardiographic features of female collegiate athletes during preparticipation evaluation. We evaluated data from 329 female athletes at two National Collegiate Athletic Association (NCAA) Division I universities who underwent preparticipation evaluation that included medical history, physical examination, 12-lead electrocardiography, and 2-dimensional transthoracic echocardiography. BP values were divided into categories of normal, elevated, stage 1 and stage 2 hypertension based on 2017 ACC/AHA Guidelines. Left ventricular mass index was calculated and indexed to body surface area and further classified into concentric remodeling, concentric hypertrophy, and eccentric hypertrophy.

Results: Normal BP values were noted in 184 (56%) female athletes, 88 (26.7%) had elevated BP and 57 (17.3%) had BP values indicating stage 1 or 2 hypertension. The majority of participants were white (n = 136, 73.9%). There was significantly higher body surface area in female athletes with higher BP values: 1.85 ± 0.18 in the stage 1 and 2 hypertension range, 1.82 ± 0.18 in the elevated BP range versus 1.73 ± 0.16 in the normal BP range (p < 0.001).

Conclusions: There was a trend toward higher incidence of concentric and eccentric hypertrophy in athletes with higher than normal BP, however no statistical significance was noted. Elevated BP values were frequent among female collegiate athletes, and there is evidence of cardiac remodeling associated with higher BP values.

Keywords: Cardiac remodeling; Echocardiography; Female; Screening; Sports cardiology.