Longitudinal development of central systolic blood pressure in young athletes

The long-term effects of high training volumes in young competitive athletes on vascular health are still unclear. The aim of this study was to evaluate the natural course of central systolic blood pressure (cSBP) over time from longitudinal assessment in young athletes.

Prospective longitudinal cohort study.

512 children and adolescents (13.4 ± 1.9 years at first measurement, n = 70 girls) were assessed for cSBP between 2012 and 2024. Over a mean follow-up period of 2.2 ± 1.3 years, 1432 follow-up assessments have been conducted. cSBP was noninvasively assessed by oscillometric measurement via Mobil-O-Graph. A linear mixed effect model was performed to examine the course of cSBP over time.

Participants trained on average 8.7 ± 3.5 h per week. cSBP increased significantly over time by 1.90 mmHg per year of age (p < 0.001, 95 % CI 1.64-2.48). The longitudinal increase in cSBP over time remained significant after including sex (β = 1.95, p < 0.001), BMI (β = 1.36, p < 0.001), and sport category (β = 1.92, p < 0.001) into the linear mixed model. The cSBP increase over time was lower in girls compared to boys (β = -0.85, p = 0.025) and in endurance athletes compared to mixed-sport athletes (β = -0.89, p = 0.006).

This study shows a longitudinal increase of cSBP in young athletes. Boys show a steeper cSBP trajectory than girls, while endurance athletes exhibit a slower increase compared with mixed-sport athletes, suggesting sport-specific vascular adaptation. Continuous monitoring of vascular function from childhood into adulthood is recommended for this highly active cohort.