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Young, Fit – and At Risk for Hypertension?

5 min read  |  November 13, 2024  | 
Disponible en Español |

A healthy lifestyle that includes exercise and a healthy diet supports cardiovascular health. But it may not be enough for those with a family history of hypertension. Maria Delgado-Lelievre, M.D. regularly sees young adults in their teens and 20s and even athletes already showing signs of the condition.

That’s why Dr. Delgado, a hypertension and cardiovascular prevention specialist and founding director of the Comprehensive Hypertension Center at the University of Miami, recommends routine blood pressure screening and consultations for anyone with a hypertensive grandparent.

Hypertension — the medical condition of high blood pressure — is the single biggest cause of heart disease in the United States, affecting nearly 50% of the population, according to the CDC. Signs of hypertension can appear as early as post-puberty among the population with a genetic risk. However, many young people developing high blood pressure are overlooked, especially athletes.

Because so many people have a genetic risk of hypertension, Dr. Delgado thinks blood pressure tests should be a part of every athletic season.

“If you gave me the power to do something for the young population to prevent heart disease, it would be to check the blood pressure of everyone with a hypertensive family member,” she says.

What is considered hypertensive?

A blood pressure reading of 130 over 80 (or higher) is considered hypertensive, based on the guidelines from the American Heart Association.

People sometimes call the condition “the silent killer” because it often shows no symptoms. Some people may notice symptoms like shortness of breath, dizziness and headaches. Left untreated, it can lead to serious health complications, like heart disease, strokes and kidney disease.

Hypertension is genetic, so having one grandparent with a history of high blood pressure puts you at higher risk.

“If your father, mother or grandparents take blood pressure medication, you need to get screened. You only need one grandparent with a history of hypertension for it to be transmitted to future generations,” says Dr. Delgado.

The onset of hypertension varies, so a young person can develop it even when neither parent has high blood pressure. “When this happens, I tell my young patient that I guarantee your parent is going to be hypertensive eventually,” says Dr. Delgado.

Hypertension screenings allow clinicians to educate young people and their families on lifestyle choices that impact heart health.

Why athletes should be screened for hypertension

Anyone with a family history of hypertension is more likely to develop the condition, including athletes. Most people assume that eating well and exercising are enough to prevent heart disease. “We take for granted that they’re 18 or 19 and are athletes, but we don’t realize that their blood pressure can still go up,” says Dr. Delgado.

Some common behaviors among athletes can affect blood pressure.

  1. Too much sodium: Athletes eat more to fuel intense workouts. The high-calorie food these young adults choose is often high in sodium, which can raise blood pressure in some people.
  2. Supplements: Protein powders and energy drinks that enhance physical capacity and recovery can also increase blood pressure.
  3. Perseverance to push through pain: Athletes may fear reprisal and refrain from telling their coach or even parent when they experience shortness of breath or difficulty performing.
  4. Birth control pills: Birth control pills can accelerate vascular dysfunction. “Whether you’re an athlete or not, if you’re taking birth control pills and you have a family history of hypertension, you should get your blood pressure checked,” says Dr. Delgado.

How to diagnose high blood pressure

Doctors diagnose hypertension through repeated blood pressure measurements over time. “You need to monitor blood pressure because it’s not static. It will evolve through time,” says Dr. Delgado.

Dr. Delgado recommends young adults with a family history of hypertension undergo annual screening.

Patients with a borderline blood pressure range of 130/80 should ideally be tested with a cordless patch they can wear at home. Alternatively, they can use a blood pressure cuff at home twice daily and keep a two-week log.

In an evaluation at The University of Miami Health System Comprehensive Hypertension Center, Dr. Delgado asks athletes questions like:

  • Did you get short of breath when you run?
  • Have you ever passed out while you’re running?
  • Do you ever get dizzy when you stand up?
  • Are you taking supplements or drinking energy drinks?
  • How much fast food do you eat?

Medication and non-pharmacological treatments for hypertension

Young adults with a genetic risk of hypertension can make lifestyle changes to help lower their blood pressure.

These include:

  • Eating a low-sodium diet
  • Exercising regularly
  • Maintaining a healthy weight
  • Reducing stress
  • Drinking hibiscus tea twice a day

While lifestyle changes help, getting screened is essential. “In many cases, non-pharmacological regulation of blood pressure is temporary. Blood pressure eventually changes because of your age,” says Dr. Delgado.

Dr. Delgado recommends anyone with a family history of hypertension begin annual blood pressure screening after puberty. Ideally, athletes should be screened even more often.

Early and routine blood pressure screenings can improve long-term cardiovascular health. “Anyone with a family history of hypertension needs to be proactive about knowing what’s going on –– even when they’re young and even as an athlete,” says Dr. Delgado.

Call the Comprehensive Hypertension Center at 305-243-5554 to make an appointment or request an in-person or virtual visit online.


Wendy Margolin is a contributor for UHealth’s news service.


University of Miami Health System's 2023 AHA Hypertension Gold +

Tags: Dr. Maria Delgado-Lelievre, elevated blood pressure, HBP, heart care in Miami, preventative heart care

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