Elevated Blood Pressure in a High School Football Player: Case Presentation and Discussion

A case is presented of an adolescent high school athlete found to have mildly elevated systolic blood pressure (BP) at the preseason group physical examination. As part of the evaluation to clear him for participation, a graded exercise stress test was performed. The test revealed a systolic BP at peak exercise of 260 mm Hg. The rationale for hygienic and pharmacologic management of this situation is discussed, and the results of this process are detailed. This patient was finally treated with nifedipine after unacceptable results with lisinopril, pindolol, and nonpharmacological approaches. The graded exercise test can be a valuable part of the evaluation of a hypertensive athlete. Besides revealing the occasional dangerous superelevation of BP, the test results can reveal the individual's cardiovascular response to stress. This can provide insight into the etiology of and prognosis for the patient's problem. Follow-up testing should be done after any treatment is provided.