P2532Value of blood pressure measurements in both arms in olympic and paralympic athletes

Abstract

Background: Hypertension is the most prevalent risk factor for cardiovascular disease in elite athletes. ESC guidelines recommend that BP measurement during preparticipation screening should be performed according to “best clinical care”, and the International Olympic Committee recommends that BP should be measured in both arms. However, no studies have assessed the value of routine bilateral measurements. Purpose: To determine BP in elite athletes using standardised methods, and to assess the added value of BP measurements in both arms. Methods: We measured BP in athletes preparing for the Olympic and Paralympic Games in Rio 2016, as part of the preparticipation screening. After five minutes' rest, BP was measured with appropriate cuff size in a sitting position in a quiet room on a day without prior training. An automated BP device (Watch BP office, Microlife) measured BP three times simultaneously in both arms, with one minute's intervals. We calculated mean values (±SD) of the last two measurements, and graded BP according to ESC guidelines (see Figure). We used independent and paired T-test to compare between groups and within individuals, respectively. Results: 100 Olympic and 20 Paralympic athletes participating in 18 different sports disciplines were included (49 males (40.8%), mean age 26.8±6.4 years, BMI 23.2±2.9 kg/m2). Nine (7.5%) had high BP, (five of them in one arm only), and 22 (18.3%) had high-normal BP. 36 athletes (30.0%) had a difference of >5 mm Hg in systolic BP between arms (mean 8.4±4.3 mm Hg), included five (4.2%) with a difference of >10 mm Hg. There were no significant differences between Olympic and Paralympic athletes. Conclusions: One quarter of Olympic and Paralympic athletes had high or highnormal BP, and one third had a BP difference of >5 mm Hg between arms. BP is an important part of preparticipation screening of athletes. Elevated BP can easily be missed if BP is measured in one arm only, and BP should therefore be measured in both arms.