Prevalence of Hypertension in Young Athletes: A Community-Based Screening Analysis

Although athletes are often perceived as low risk for cardiovascular disease, emerging evidence suggests they may still experience elevated blood pressure (BP). The prevalence and determinants of hypertension (HTN) in young athletes remain underexplored.

The objectives of the study were to determine the prevalence of elevated BP in a community-based cohort of young individuals, compare BP categories between athletes and nonathletes, and identify demographic, socioeconomic, environmental, and sport-related factors associated with HTN.

We conducted a retrospective analysis of 1,987 individuals aged 9 to 35 years who attended free community cardiovascular screenings from 2016 to 2024. BP was measured using standardized protocols and classified per 2017 American Heart Association/American College of Cardiology guidelines. Multivariable ordinal logistic regression evaluated associations between HTN category and athlete status, sex, age, body mass index, socioeconomic status, air pollution exposure (particulate matter <2.5 μm), and environmental burden (CalEnviroScreen score). Athletes were additionally stratified by the isometric load of reported sports.

The median age was 15.7 years and 47.9% were females. Overall, 22.7% were classified as pre-HTN, 12.0% as stage I HTN, and 6.6% as stage II HTN. HTN prevalence did not differ significantly between athletes and nonathletes (P = 0.17). Higher BP category was associated with male sex, increased age, elevated body mass index, and lower socioeconomic status. Neither particulate matter <2.5 μm nor environmental burden predicted HTN. No significant difference in HTN prevalence was found across sport types with varying isometric loads.

Elevated BP is common in young individuals, including athletes. These findings underscore the importance of BP screening in youth, regardless of athletic status, and highlight the influence of demographic and socioeconomic risk factors.