perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”perinatology-117Research ArticleКАРДИОЛОГИЯCARDIOLOGYАртериальная гипертензия у детей-спортсменовHypertension in child athletesБалыковаЛ. А.BalykovaL. A.

д.м.н., проф., зав. кафедрой педиатрии, директор Медицинского института Мордовского государственного университета им. Н.П. Огарева

ИвянскийС. А.IvyanskyS. A.

к.м.н., ст. преподаватель той же кафедры

ЩекинаН. В.ShchekinaN. V.

зав. отделением кардиоревматологии Детской республиканской клинической больницы430032 Саранск, ул Р. Люксембург, 15А

МихееваК. Н.MikheevaK. N.

соискатель кафедры педиатрии, директор Медицинского института Мордовского государственного университета им. Н.П. Огарева 

УрзяеваА. М.UrziaevaA. N.

аспирант кафедры педиатрии, директор Медицинского института Мордовского государственного университета им. Н.П. Огарева

ФГБОУ ВПО «Мордовский государственный университет им. Н.П. Огарева»РоссияN.R Ogarev Mordovia State UniversityRussian FederationГБУЗ РМ «Детская республиканская клиническая больница», СаранскРоссияRepublic Children's Clinical Hospital, SaranskRussian Federation2015130320166064854Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20162016Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/117

Представлен обзор данных литературы, касающихся распространенности и причин артериальной гипертензии у спортсменов. Рассмотрены различные точки зрения на влияние регулярных физических нагрузок на уровень артериального давления. Кроме того, описаны имеющиеся подходы к выявлению и лечению повышенного артериального давления у детей и подростков, занимающихся спортом. Приведены результаты собственных наблюдений по выявлению гипертензии и факторов ее риска у юных атлетов. Показана необходимость комплексного подхода к диагностике данного состояния в спорте с использованием суточного мониторирования артериального давления, эхокардиографии и нагрузочного тестирования. Разработаны нормы реакции артериального давления на дозированную физическую нагрузку у спортсменов 12—16 лет. На основе собственных данных, а также отечественного и зарубежного опыта представлен оригинальный алгоритм наблюдения молодых спортсменов с артериальной гипертензией.

The paper reviews literature data on the prevalence and causes of hypertension in athletes. It considers different points of view on the impact of regular physical activities on blood pressure levels. It also describes available diagnostic approaches to identifying and treating higher blood pressure in children and adolescents going in for sports. The authors give the results of their observations identifying hypertension and its risk factors in young athletes. They show it necessary to apply an integrated approach to diagnosing this condition in sports, by making 24-hour blood pressure monitoring, echocardiography, and exercise testing. Standards for a normal blood pressure response to graduated exercise have been developed in 12 -16-year-old athletes. Based on their own findings and Russian and foreign experience, the authors present an original algorithm for following up young athletes with hypertension.

дети-спортсменыартериальная гипертензияфизическая нагрузкаартериальное давление.pediatric athleteshypertensionexerciseblood pressure.ReferencesBassareo P.P., Метит G. WJC 6th Anniversary Special Issues (1): Hypertension Pediatric hypertension: An update on a burning problem. World J Cardiol 2014; 6: 5: 253-259.Bassareo P.P., Метит G. WJC 6th Anniversary Special Issues (1): Hypertension Pediatric hypertension: An update on a burning problem. World J Cardiol 2014; 6: 5: 253-259.RosnerB., CookN.R., Daniels S., FalknerB. Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure: The NHANES Experience 1988-2008. Hypertension 2013; 62: 247-254.RosnerB., CookN.R., Daniels S., FalknerB. Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure: The NHANES Experience 1988-2008. Hypertension 2013; 62: 247-254.Sun S. S., Grave G. D., Siervogel R. M. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics 2007; 119: 2: 237-246.Sun S. S., Grave G. D., Siervogel R. M. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics 2007; 119: 2: 237-246.Steinberger J., Daniels S., Eckel R. et al. Progress and Challenges in Metabolic Syndrome in Children and Adolescents. A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 2009; 119: 1-20.Steinberger J., Daniels S., Eckel R. et al. Progress and Challenges in Metabolic Syndrome in Children and Adolescents. A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 2009; 119: 1-20.Kavey R.E., Allada V., Daniels S.R. et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2006; 114: 24:2710-2738.Kavey R.E., Allada V., Daniels S.R. et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2006; 114: 24:2710-2738.Parker E.D., Schmitz K.H., Jacobs D.R.J. et al. Physical activity in young adults and incident hypertension over 15 years of follow-up: the CARDIA Study. Am J Public Health. 2007; 97: 703-709.Parker E.D., Schmitz K.H., Jacobs D.R.J. et al. Physical activity in young adults and incident hypertension over 15 years of follow-up: the CARDIA Study. Am J Public Health. 2007; 97: 703-709.Dimeo E, Pagonas N., Seibert F. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension 2012; 60: 3: 653-658.Dimeo E, Pagonas N., Seibert F. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension 2012; 60: 3: 653-658.Palatini P. Cardiovascular effects of exercise in young hypertensives. Int J Sports Med 2012; 33: 9: 683-690.Palatini P. Cardiovascular effects of exercise in young hypertensives. Int J Sports Med 2012; 33: 9: 683-690.Cornelissen V.A., Fagard R.H., Coeckelberghs E., Vanhees L. Impact of Resistance Training on Blood Pressure and Other Cardiovascular Risk Factors: A Meta-Analysis of Randomized, Controlled Trials. Hypertension 2011; 58: 950-958.Cornelissen V.A., Fagard R.H., Coeckelberghs E., Vanhees L. Impact of Resistance Training on Blood Pressure and Other Cardiovascular Risk Factors: A Meta-Analysis of Randomized, Controlled Trials. Hypertension 2011; 58: 950-958.Berge H.M., Isern СВ., Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med 2015; 49: 11:716-723.Berge H.M., Isern СВ., Berge E. Blood pressure and hypertension in athletes: a systematic review. Br J Sports Med 2015; 49: 11:716-723.SharmaS., MerghaniA., MontL. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J 2015; 36:23: 1445-1453.SharmaS., MerghaniA., MontL. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J 2015; 36:23: 1445-1453.Corrado D., Pelliccia A., Bjornstad H.H. et al. Cardiovascular preparticipation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocar-dial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 516-524.Corrado D., Pelliccia A., Bjornstad H.H. et al. Cardiovascular preparticipation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocar-dial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 516-524.Kjeldsen S.E., Mundal R., Sandvik L. et al Supine and exercise systolic blood pressure predict cardiovascular death in middle-aged men. JHypertens 2001; 19: 1343-1348.Kjeldsen S.E., Mundal R., Sandvik L. et al Supine and exercise systolic blood pressure predict cardiovascular death in middle-aged men. JHypertens 2001; 19: 1343-1348.Садыкова Д.И., Латфуллин И.Я. Эссенциальная артериальная гипертензия у спортсменов Каз мед журн 2012; 93: 6: 927-931. (Sadykova D.I., Latfullin I.Ya. Arterial hypertension in athletes. Kaz med zhurn 2012; 93: 6: 927-931.Садыкова Д.И., Латфуллин И.Я. Эссенциальная артериальная гипертензия у спортсменов Каз мед журн 2012; 93: 6: 927-931. (Sadykova D.I., Latfullin I.Ya. Arterial hypertension in athletes. Kaz med zhurn 2012; 93: 6: 927-931.Bruno R.M., Cartoni G., Taddei S. Hypertension in special populations: athletes. Future Cardiol 2011; 7: 4: 571-584.Bruno R.M., Cartoni G., Taddei S. Hypertension in special populations: athletes. Future Cardiol 2011; 7: 4: 571-584.Leyk D., RitherL, Wunderlich M. etal. Utilization and Implementation of Sports Medical Screening Examinations: Survey of More Than 10000 Long-Distance Runners. Dtsch Arztebl Int 2008; 105: 36: 609-614.Leyk D., RitherL, Wunderlich M. etal. Utilization and Implementation of Sports Medical Screening Examinations: Survey of More Than 10000 Long-Distance Runners. Dtsch Arztebl Int 2008; 105: 36: 609-614.Trachsel L.D., Carlen F, Brugger N. et al. Masked hypertension and cardiac remodeling in middle-aged endurance athletes. JHypertens 2015; 33: 6: 1276-1283.Trachsel L.D., Carlen F, Brugger N. et al. Masked hypertension and cardiac remodeling in middle-aged endurance athletes. JHypertens 2015; 33: 6: 1276-1283.Александров А.А., Кисляк О.А., Леонтьева И.В. и др. Диагностика, лечение и профилактика артериальной гипер-тензии у детей и подростков. Клинические рекомендации Всероссийского научного общества кардиологов, Российского медицинского общества по артериальной гипертонии, Ассоциации детских кардиологов России. Второй пересмотр. Кардиоваскулярная терапия и профилактика 2009; 8: 4: Приложение 1: 253-288. (Aleksandrov A.A., Kislyak O.A., Leont'eva I.V. et al. Diagnostics, treatment, and management arterial hypertension in children and adolescents Clinical guidelines of Russian Cardiology' Society, Russian medical Society of arterial hypertension, Pediatrics' Cardiology Association of Russia. Second update. Kardiovaskulyarnaya terapiyaiprofflaktika2009; 8: 4: Suppl 1: 253-288).Александров А.А., Кисляк О.А., Леонтьева И.В. и др. Диагностика, лечение и профилактика артериальной гипер-тензии у детей и подростков. Клинические рекомендации Всероссийского научного общества кардиологов, Российского медицинского общества по артериальной гипертонии, Ассоциации детских кардиологов России. Второй пересмотр. Кардиоваскулярная терапия и профилактика 2009; 8: 4: Приложение 1: 253-288. (Aleksandrov A.A., Kislyak O.A., Leont'eva I.V. et al. Diagnostics, treatment, and management arterial hypertension in children and adolescents Clinical guidelines of Russian Cardiology' Society, Russian medical Society of arterial hypertension, Pediatrics' Cardiology Association of Russia. Second update. Kardiovaskulyarnaya terapiyaiprofflaktika2009; 8: 4: Suppl 1: 253-288).MiyachiM., Kawano H., Sugawara J. et al. Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study Circulation 2004; 110: 2858-2863.MiyachiM., Kawano H., Sugawara J. et al. Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study Circulation 2004; 110: 2858-2863.Pavlik G., Major Z, Csajagi E. et al. The athlete's heart. Part II: influencing factors on the athlete's heart: types of sports and age (review). ActaPhysiol Hung 2013; 100: 1: 1-27.Pavlik G., Major Z, Csajagi E. et al. The athlete's heart. Part II: influencing factors on the athlete's heart: types of sports and age (review). ActaPhysiol Hung 2013; 100: 1: 1-27.Helzberg J.H., Waeckerle J.F., Camilo J. et al Comparison of cardiovascular and metabolic risk factors in professional baseball players versus professional football players. Am J Cardiol 2010; 106: 5: 664-667.Helzberg J.H., Waeckerle J.F., Camilo J. et al Comparison of cardiovascular and metabolic risk factors in professional baseball players versus professional football players. Am J Cardiol 2010; 106: 5: 664-667.Balady G.J., Drezner J.A. Tackling cardiovascular health risks in college football players. Circulation 2013; 128: 5: 477-480.Balady G.J., Drezner J.A. Tackling cardiovascular health risks in college football players. Circulation 2013; 128: 5: 477-480.CarbuhnA.F., WomackJ.W., Green J.S. etal. Performance and blood pressure characteristics of first-year national collegiate athletic association division I football players. J Strength Cond Res 2008; 22: 4: 1347-1354.CarbuhnA.F., WomackJ.W., Green J.S. etal. Performance and blood pressure characteristics of first-year national collegiate athletic association division I football players. J Strength Cond Res 2008; 22: 4: 1347-1354.Mahmud A., Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens 2003; 16: 229-232.Mahmud A., Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens 2003; 16: 229-232.Weiner R.B., Wang F, Isaacs S.K. et al. Blood pressure and left ventricular hypertrophy during american-style football participation Circulation 2013; 128: 524—531.Weiner R.B., Wang F, Isaacs S.K. et al. Blood pressure and left ventricular hypertrophy during american-style football participation Circulation 2013; 128: 524—531.Allen T.W., Vogel R.A., Lincoln A.E. et al. Body size, body composition, and cardiovascular disease risk factors in NFL players. Phys Sportsmed 2010; 38: 1: 21-27.Allen T.W., Vogel R.A., Lincoln A.E. et al. Body size, body composition, and cardiovascular disease risk factors in NFL players. Phys Sportsmed 2010; 38: 1: 21-27.Baron S.L., Hein M.J., Lehman E., Gersic CM. Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. Am J Cardiol 2012; 109: 6: 889-896.Baron S.L., Hein M.J., Lehman E., Gersic CM. Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. Am J Cardiol 2012; 109: 6: 889-896.Tucker A., Vogel R., Lincoln A. et al. Prevalence of cardiovascular disease risk factors among national football league players. JAMA 2009; 301: 20: 2111-2119.Tucker A., Vogel R., Lincoln A. et al. Prevalence of cardiovascular disease risk factors among national football league players. JAMA 2009; 301: 20: 2111-2119.Dixit S., Hecht S., Concoff A. Cardiovascular risk factors in football players. Curr Sports Med Rep 2011; 10: 6: 378-382.Dixit S., Hecht S., Concoff A. Cardiovascular risk factors in football players. Curr Sports Med Rep 2011; 10: 6: 378-382.Baggish A.L., Weiner R.B., Yared K. et al. Impact of family hypertension history on exercise-induced cardiac remodeling. Am J Cardiol 2009; 104: 1: 101-106.Baggish A.L., Weiner R.B., Yared K. et al. Impact of family hypertension history on exercise-induced cardiac remodeling. Am J Cardiol 2009; 104: 1: 101-106.Whelton P.K., Appel L.J., Sacco R.L. et al. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012; 126: 2880-2889.Whelton P.K., Appel L.J., Sacco R.L. et al. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012; 126: 2880-2889.Laine M.K., Kujala U.M., Eriksson J.G. Former male elite athletes and risk of hypertension in later life. J Hypertens 2015; 33: 8: 1549-1554.Laine M.K., Kujala U.M., Eriksson J.G. Former male elite athletes and risk of hypertension in later life. J Hypertens 2015; 33: 8: 1549-1554.Karpinos A.R., Roumie C.L., Man H. et al. High prevalence of hypertension among collegiate football athletes. Circ Cardio-vasc Qual Outcomes 2013; 6: 6: 716-723.Karpinos A.R., Roumie C.L., Man H. et al. High prevalence of hypertension among collegiate football athletes. Circ Cardio-vasc Qual Outcomes 2013; 6: 6: 716-723.Pokharel Y, Macedo F. Y, Nambi V. et al. Neck circumference is not associated with subclinical atherosclerosis in retired National Football League players, din Cardiol 2014; 37:7:402-407.Pokharel Y, Macedo F. Y, Nambi V. et al. Neck circumference is not associated with subclinical atherosclerosis in retired National Football League players, din Cardiol 2014; 37:7:402-407.Guo J., Zhang X., Wang L. et al. Prevalence of metabolic syndrome and its components among Chinese professional athletes of strength sports with different body weight categories. PLoS ONE 2013; 8: 11: e79758.Guo J., Zhang X., Wang L. et al. Prevalence of metabolic syndrome and its components among Chinese professional athletes of strength sports with different body weight categories. PLoS ONE 2013; 8: 11: e79758.Cis SpoturnoA.C, Paz-Sauquillo M. Т., Lopez-Zea M., Fernkn-dez-Rostello E.A. Cardiovascular risk factors encountered during medical examination in athletic children. Arch Argent Pe-diatr 2013; 111:6:472-475.Cis SpoturnoA.C, Paz-Sauquillo M. Т., Lopez-Zea M., Fernkn-dez-Rostello E.A. Cardiovascular risk factors encountered during medical examination in athletic children. Arch Argent Pe-diatr 2013; 111:6:472-475.O'Farrell A.M., Allwright S.P., Kenny S.C., Roddy G. Alcohol use among amateur sportsmen in Ireland. BMC Research Notes 2010; 3:313.O'Farrell A.M., Allwright S.P., Kenny S.C., Roddy G. Alcohol use among amateur sportsmen in Ireland. BMC Research Notes 2010; 3:313.AngellP., Chester N., Green D. etal. Anabolic steroids and cardiovascular risk. Sports Med2012; 42: 2: 119-134.AngellP., Chester N., Green D. etal. Anabolic steroids and cardiovascular risk. Sports Med2012; 42: 2: 119-134.Gheshlaghi F., Piri-Ardakani M.R., Masoumi G.R. et al. Cardiovascular manifestations of anabolic steroids in association with demographic variables in body building athletes. J Res MedSci 2015; 20: 2: 165-168.Gheshlaghi F., Piri-Ardakani M.R., Masoumi G.R. et al. Cardiovascular manifestations of anabolic steroids in association with demographic variables in body building athletes. J Res MedSci 2015; 20: 2: 165-168.Diehl K, ThielA., Zipfel S. et al. Elite adolescent athletes' use of dietary supplements: characteristics, opinions, and sources of supply and information. Int J Sport Nutr Exerc Metab 2012; 22: 3: 165-174.Diehl K, ThielA., Zipfel S. et al. Elite adolescent athletes' use of dietary supplements: characteristics, opinions, and sources of supply and information. Int J Sport Nutr Exerc Metab 2012; 22: 3: 165-174.Perera N.J., Steinbeck K.S., Shackel N. The adverse health consequences of the use of multiple performance-enhancing substances -a deadly cocktail. J Clin Endocrinol Metab 2013; 98:12:4613-4618.Perera N.J., Steinbeck K.S., Shackel N. The adverse health consequences of the use of multiple performance-enhancing substances -a deadly cocktail. J Clin Endocrinol Metab 2013; 98:12:4613-4618.PetrocziA., Naughton D.P., Pearce G. et al. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy. J Int Soc Sports Nutr 2008; 5: 22.PetrocziA., Naughton D.P., Pearce G. et al. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy. J Int Soc Sports Nutr 2008; 5: 22.Cubera I.G. Left ventricular mass index and sports: the influence of different Sports activities and arterial blood pressure Int J Cardiol 2000; 75: 2: 261-265.Cubera I.G. Left ventricular mass index and sports: the influence of different Sports activities and arterial blood pressure Int J Cardiol 2000; 75: 2: 261-265.Смоленский А.В., Золичева С.Ю., Михайлова А.В. и др. Морфофункциональные отличия юных гребцов с повышенным уровнем артериального давления. Физиол чел 2010; 4: 15-19. (Smolenskij A.V., Zolicheva S.Yu., Mihajlova A.V. et al. Morpho-functional changes of young rowers with arterial hypertension. Fiziol chel 2010; 4: 15—19.Смоленский А.В., Золичева С.Ю., Михайлова А.В. и др. Морфофункциональные отличия юных гребцов с повышенным уровнем артериального давления. Физиол чел 2010; 4: 15-19. (Smolenskij A.V., Zolicheva S.Yu., Mihajlova A.V. et al. Morpho-functional changes of young rowers with arterial hypertension. Fiziol chel 2010; 4: 15—19.Khoury Ph.R., Mitsnefes M., Daniels S.R., Kimball T.R. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009; 22: 709-714.Khoury Ph.R., Mitsnefes M., Daniels S.R., Kimball T.R. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009; 22: 709-714.Caselli S., Maron M.S., Urbano-Moral J.A. et al. Differentiating left ventricular hypertrophy in athletes from that in patients with hypertrophic cardiomyopathy. Am J Cardiol 2014; 114:9:1383-1389.Caselli S., Maron M.S., Urbano-Moral J.A. et al. Differentiating left ventricular hypertrophy in athletes from that in patients with hypertrophic cardiomyopathy. Am J Cardiol 2014; 114:9:1383-1389.Utomi V., Oxborough D., Whyte G.P. et al. Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. Heart 2013; 99: 23: 1727-1733.Utomi V., Oxborough D., Whyte G.P. et al. Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. Heart 2013; 99: 23: 1727-1733.Petriz, B.A., Franco O.L. Effects of hypertension and exercise on cardiac proteome remodelling. Biomed Res Int 2014; 2014: 634132.Petriz, B.A., Franco O.L. Effects of hypertension and exercise on cardiac proteome remodelling. Biomed Res Int 2014; 2014: 634132.Galderisi M., Lomoriello V.S., Santoro A. et al. Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study. J Am Soc Echocardiogr 2010; 23: 11: 1190-1198.Galderisi M., Lomoriello V.S., Santoro A. et al. Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study. J Am Soc Echocardiogr 2010; 23: 11: 1190-1198.National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555-576.National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555-576.Бойцов С.А. Колос И.П., Лидов П.И., Смоленский А.В. Объединенная рабочая группа по подготовке рекомендаций Всероссийского научного общества кардиологов (ВНОК), Российской ассоциации по спортивной медицине и реабилитации больных и инвалидов (РАСМИРБИ),Бойцов С.А. Колос И.П., Лидов П.И., Смоленский А.В. Объединенная рабочая группа по подготовке рекомендаций Всероссийского научного общества кардиологов (ВНОК), Российской ассоциации по спортивной медицине и реабилитации больных и инвалидов (РАСМИРБИ),Российского общества холтеровского мониторирования и неинвазивной электрофизиологии (РОХМИНЭ), Ассоциации детских кардиологов России. Национальные рекомендации по допуску к занятиям спортом и участию в соревнованиях спортсменов с отклонениями со стороны сердечно-сосудистой системы Рац фармакотерап в карди-ол 2011; 7: 6: Приложение: 2-60. (Bojcov S.A. Kolos I.P., Lidov P.I., Smolenskiy A.V. Joint Working group on recommendations preparation of the All-Russian scientific societies of cardiologists (VNOK), the Russian association on sports medicine and rehabilitation of patients and disabled people (RASMIRBI), the Russian society of Holter monitoring and a noninvasive electrophysiology (ROHMINE), Association Pe-diatrics's cardiologists of Russia. National recommendations about sport activity admission and competition participation in in athletes with cardiovascular disorders. Rats farmakoterap v kardiol 2011; 7: 6: Suppl: 2-60.)Российского общества холтеровского мониторирования и неинвазивной электрофизиологии (РОХМИНЭ), Ассоциации детских кардиологов России. Национальные рекомендации по допуску к занятиям спортом и участию в соревнованиях спортсменов с отклонениями со стороны сердечно-сосудистой системы Рац фармакотерап в карди-ол 2011; 7: 6: Приложение: 2-60. (Bojcov S.A. Kolos I.P., Lidov P.I., Smolenskiy A.V. Joint Working group on recommendations preparation of the All-Russian scientific societies of cardiologists (VNOK), the Russian association on sports medicine and rehabilitation of patients and disabled people (RASMIRBI), the Russian society of Holter monitoring and a noninvasive electrophysiology (ROHMINE), Association Pe-diatrics's cardiologists of Russia. National recommendations about sport activity admission and competition participation in in athletes with cardiovascular disorders. Rats farmakoterap v kardiol 2011; 7: 6: Suppl: 2-60.)Demorest R., Washington R. Council on Sports Medicine and Fitness. Athletic participation by children and adolescents who have systemic hypertension. Pediatrics 2010; 125: 1287-1294.Demorest R., Washington R. Council on Sports Medicine and Fitness. Athletic participation by children and adolescents who have systemic hypertension. Pediatrics 2010; 125: 1287-1294.Urbina E., Alpert В., Flynn J. et al. Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment. A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research. Hypertension 2008; 52: 433-451.Urbina E., Alpert В., Flynn J. et al. Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment. A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research. Hypertension 2008; 52: 433-451.Макаров Л.М., Федина Н.Н., Комолятова В.Н. и др. Нормативные параметры артериального давления у юных элитных спортсменов при пробе с дозированной физической нагрузкой. Педиатрия 2015; 94: 2: 102—104. (Makarov L.M., Fedina N.N., Komolyatova V.N. et al The norm value of arterial blood pressure in young athletes during exercise test. Pediatriya2015; 94: 2: 102-104.)Макаров Л.М., Федина Н.Н., Комолятова В.Н. и др. Нормативные параметры артериального давления у юных элитных спортсменов при пробе с дозированной физической нагрузкой. Педиатрия 2015; 94: 2: 102—104. (Makarov L.M., Fedina N.N., Komolyatova V.N. et al The norm value of arterial blood pressure in young athletes during exercise test. Pediatriya2015; 94: 2: 102-104.)Деев В.В., Бадтиева В.А., Павлов В.И., Орджоникидзе 3.F. О критериях гипертензии в спорте. Тезисы докладов 15-го Конгресса Российского общества холтеровского мониторирования и неинвазивной электрофизиологии (РОХ-МиНЭ), 7-го Всероссийского конгресса «Клиническая электрокар-диология», 23—24 апреля 2014, Белгород М.: ООО «Дизарт Тим», 2014; 49-50. (Deev V.V., Badtieva V.A., Pavlov V.I., Ordzhonikidze Z.G. About hypertension criteria in sport. Absracts of 15 Congress of Russia society of Holter monitoring and noninvaisive electrophysiology (ROHMiNE), 7 Russia Congress «Clinical electrocardiology», 23—24 April 2014, Belgorod M.: OOO «Dizart Tim», 2014; 49-50.)Деев В.В., Бадтиева В.А., Павлов В.И., Орджоникидзе 3.F. О критериях гипертензии в спорте. Тезисы докладов 15-го Конгресса Российского общества холтеровского мониторирования и неинвазивной электрофизиологии (РОХ-МиНЭ), 7-го Всероссийского конгресса «Клиническая электрокар-диология», 23—24 апреля 2014, Белгород М.: ООО «Дизарт Тим», 2014; 49-50. (Deev V.V., Badtieva V.A., Pavlov V.I., Ordzhonikidze Z.G. About hypertension criteria in sport. Absracts of 15 Congress of Russia society of Holter monitoring and noninvaisive electrophysiology (ROHMiNE), 7 Russia Congress «Clinical electrocardiology», 23—24 April 2014, Belgorod M.: OOO «Dizart Tim», 2014; 49-50.)Mancia G., Fagard R., Narkiewicz К 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: 2159-2219.Mancia G., Fagard R., Narkiewicz К 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: 2159-2219.Leischik R., Spelsberg N., Niggemann H. et al. Exercise-induced arterial hypertension — an independent factor for hypertrophy and a ticking clock for cardiac fatigue or atrial fibrillation in athletes? F1000 Research 2014; 3: 105.Leischik R., Spelsberg N., Niggemann H. et al. Exercise-induced arterial hypertension — an independent factor for hypertrophy and a ticking clock for cardiac fatigue or atrial fibrillation in athletes? F1000 Research 2014; 3: 105.The World Anti-Doping Code THE 2015 PROHIBITED LIST INTERNATIONAL STANDARD The official text of the Prohibited List shall be maintained by WADA and shall be published in English and French. https://wada-main-prod. s3.amazonaws.com/resources/files/wada-2015-prohibited-list-en.pdfThe World Anti-Doping Code THE 2015 PROHIBITED LIST INTERNATIONAL STANDARD The official text of the Prohibited List shall be maintained by WADA and shall be published in English and French. https://wada-main-prod. s3.amazonaws.com/resources/files/wada-2015-prohibited-list-en.pdfAsplund C. Treatment of hypertension in athletes: an evidence-based review. Phys Sportsmed 2010; 38: 1: 37—44.Asplund C. Treatment of hypertension in athletes: an evidence-based review. Phys Sportsmed 2010; 38: 1: 37—44.Oliveira L.P., Lawless C.E. Hypertension update and cardiovascular risk reduction in physically active individuals and athletes. Phys Sportsmed 2010; 38: 1: 11-20.Oliveira L.P., Lawless C.E. Hypertension update and cardiovascular risk reduction in physically active individuals and athletes. Phys Sportsmed 2010; 38: 1: 11-20.

The authors declare that there are no conflicts of interest present.