Dear Dr. Levister: My overweight 13 year old son suffers from mild high blood pressure. Is it safe to let him play competitive sports this summer? R.H.
Dear R.H.: First Lady Michelle Obama’s national campaign Let’s Move! has an ambitious but important goal: to solve the epidemic of childhood obesity within a generation. But parents are urged to take precautions before signing children up for intense physical activity and certain competitive sports. Most children and teenagers with mildly elevated blood pressure can safely participate in sports, but those with more-serious high blood pressure need to get the condition under control before they can take part in high-intensity sports, according to new recommendations.
According to the American Academy of Pediatrics (AAP), children and teens with "pre-hypertension" -- blood pressure that is elevated but not high enough for a diagnosis of high blood pressure -- should be eligible for all competitive sports. They should also, however, make any needed lifestyle changes to lower their blood pressure, and continue to have their numbers checked every six months. Those lifestyle changes include regular exercise, a well-balanced diet and, if necessary, weight loss, the AAP writes in its journal, Pediatrics.
The recommendations are similar for kids who have what is known as stage 1 hypertension.
According to the academy, they should be eligible for all competitive sports as long as they have no major organ damage related to their blood pressure -- such as enlargement in the heart's main pumping chamber or any other form of heart disease.
Children and teenagers with stage 1 high blood pressure should also have the diagnosis confirmed with a repeat measurement one to two weeks later, according to the AAP. Lifestyle changes are recommended as treatment, while some kids may need to be referred to a pediatrician who specializes in cardiovascular problems -- particularly those with heart problems or who have consistently high numbers on several blood-pressure measurements over time.
According to the AAP, all athletes with pre-hypertension or high blood pressure should limit substances that could cause blood-pressure spikes -- including caffeine, certain medications (like common over-the-counter painkillers and decongestants), tobacco and stimulants.
The academy also points out that obese youngsters are at particular risk of high blood pressure, and while extra weight is valued in certain sports, such as football, young athletes should not be encouraged to bulk up.
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