PDF(Pubmed)
Abstract：
Cardiovascular disease (CVD) is the most common cause of death globally in general population. Sport activity is an effective and recommended non-pharmacological method of CVD prevention. Presently, the group of people practicing sport regularly is constantly growing due to increasing awareness of its health benefits. However, vigorous-intensity exercises can reveal previously undetected disease. Master athletes over 35 years old are particularly exposed to sudden cardiac death (SCD) mainly in the course of coronary artery disease (CAD). Another common disease in veteran athletes is hypertension. It is known that regular endurance training can lower blood pressure at rest, so arterial hypertension in athletes is usually masked by adaptation to effort. Despite of normal or high-normal blood pressure in the office, the values during exercises and in ambulatory blood pressure monitoring (ABPM) can exceed the norm. Hidden hypertension have the same negative impact on cardiovascular system. It increases the risk of (1) atherosclerosis and therefore myocardial infarction or stroke, (2) left ventricular hypertrophy with diastolic and/or systolic heart failure, myocardial fibrosis and ventricular arrhythmias, (3) left atrial enlargement increasing the risk of atrial fibrillation and stroke and (4) aortic dilation/dissection. Through these complications hypertension can lead to SCD during sport activities, therefore it is important to recognize this disease early and start a proper treatment. To enable safe participation in sports competition detailed guidelines for screening were created, but they mainly concern CAD. We propose an additional scheme of screening in master athletes including the detection of hidden hypertension to prevent its consequences.
摘要：
心血管疾病（CVD）是全球普通人群中最常见的死亡原因。运动活动是预防CVD的有效和推荐的非药物方法。目前,由于人们对运动的健康益处的认识日益提高，经常练习运动的人群不断增长。然而,剧烈运动可以揭示以前未被发现的疾病。35岁以上的大师运动员特别容易遭受心源性猝死（SCD），主要是在冠状动脉疾病（CAD）过程中。资深运动员的另一种常见疾病是高血压。众所周知，定期进行耐力训练可以降低休息时的血压，所以运动员的动脉高血压通常被对努力的适应所掩盖。尽管办公室血压正常或正常偏高，运动和动态血压监测（ABPM）中的值可能会超过正常值。隐性高血压对心血管系统也有同样的负面影响。它增加了（1）动脉粥样硬化的风险，因此心肌梗塞或中风，（2）左心室肥厚伴舒张和/或收缩性心力衰竭，心肌纤维化和室性心律失常,（3）左心房扩大增加房颤和中风的风险；（4）主动脉扩张/夹层。通过这些并发症，高血压可以在运动活动中导致SCD，因此，早期认识到这种疾病并开始适当的治疗是很重要的。为了安全参加体育比赛，制定了详细的筛查指南，但他们主要关注CAD。我们提出了一种对主要运动员进行筛查的额外方案，包括检测隐性高血压以防止其后果。
