Pheno-genotypical features of masked hypertension in athletes in the Republic of Sakha (Yakutia)

Objective. The aim of the study is to identify pathogenetic features of the development of masked hypertension in athletes in the Republic of Sakha (Yakutia).

Design and methods. We enrolled 205 young men and males: 147 athletes with different orientations of training activity (cyclic sports and martial arts) and 58 control individuals without physical activity. All subjects underwent 24-hour blood pressure (BP) monitoring, anthropometry, echocardiography, assessment of central hemodynamics, and a genetic study.

Results. Despite similar sports experience, 40,8 % athletes have masked hypertension, which is more common among athletes with the “master of sports” qualification (χ² = 5,68, df = 1, p = 0,013) and does not depend on sport type (χ² = 2,09, df = 1, p = 0,107). Athletes with masked hypertension showed nocturnal hypertension, decreased myocardial function, and a high rate of left ventricular structural remodeling.

Conclusions. We identified the following genetic and phenotypic features: associations of gene polymorphisms responsible for the development of hypertension, episodes of insufficient nighttime BP decline, nocturnal hypertension, structural remodeling of the heart. These findings suggest that people with masked hypertension show cardiovascular overstrain at rest, which considering excessive physical load can lead to target-organ damage. This pathogenetic factors can be considered as phenogenotypic predictors of hypertension development and require further investigation.

1. National recommendations on the admission of athletes with impaired cardiovascular system to the training and competition process. Rational Pharmacotherapy in Cardiology. 2011;6:2-60. In Russian.

2. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-2219.

3. Clement D, De Buyzere M, De Bacquer D, de Leeuw PW, Duprez DA, Fagard RH et al. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med. 2003;348(24):2407-2415.

4. Fagard RH, Cornelissen VA. Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension: a meta-analysis. J Hypertens. 2007;25(11):2193-2198.

5. ESC/ESH Guidelines for the management of arterial hypertension, 2018. Russ J Cardiology. 2018;23(12):143-228. http://dx.doi.org/10.15829/1560-4071-2018-12-143-228. In Russian.

6. Guidelines for the management of arterial hypertension (ESH/ESC). J Hypertens. 2013;31(7):1281-1357.

7. Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med. 2002;347(11):797-805.

8. Kouno Т, Katsumata N, Mukai H, Ando M, Watanabe T. Standardization of the body surface area (BSA) formula to calculate the dose of anticancer agents in Japan. Jpn J Clin Oncol. 2003;33(6)309-313.

9. Bryn VB, Zonis BYa. Physiology of systemic circulation. Formulas and calculations. Publishing of Rostov University. 1984. 88 p. In Russian.

10. Akhmetov II. Molecular genetics of sports. M.: Sovetskiy Sport, 2009. 268 p. In Russian.

11. Posokhov IN. Isolated systomic hypertension in young adults: a case report. Arterial’naya Gipertenziya = Arterial Hypertension. 2015;21(5):530-534. doi:10.18705/1607-419X-2015-21-5-530-534. In Russian.