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| Author (year) | Study size (n) | Definition for HRE | Age (years) | Gender (% male) | Exercise testing protocol | Type of athlete | Study design | Summary of findings |
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| Currie et al. [35] | 22 | SBP 190–210 mmHg | 55.5 ± 5 | 73 | Graded exercise test | Endurance athletes | Cross-sectional | No cardiovascular dysfunction. Similar parameters of sympathetic reactivity, LV structure and function and central arterial stiffness were observed in athletes with and without HRE |
| Turmel et al. [36] | 44 | SBP ≥220 mmHg, DBP ≥110 mmHg | 20 | 63.2 | Progressive maximal aerobic exercise test (RAMP) | Endurance athletes | Cross-sectional | Athletes with HRE had a higher BP during exercise at every intensity and higher SBP during 24 h ABPM. Lower apo-A1 serum levels in athletes with HRE imply a higher risk for cardiovascular disease |
| Caselli et al. [13] | 1876 | SBP ≥220 mmHg for male, 200 mmHg for female, DBP ≥85 mmHg for male, ≥80 mmHg for female | 25 ± 6 | 64 | Symptom-limited bicycle testing; increase in workload of 0.5 W/kg every 2 min | Olympic athletes classified in 4 subgroups; skill, power, mixed, endurance | Cross-sectional | 7.5% had HRE. These athletes had larger BMI and were more commonly engaged in endurance and mixed sports |
| Leischik et al. [37] | 51 | No definition | 37 | 100 | Progressive maximal aerobic exercise test (RAMP) | Triathletes | Cross-sectional | Athletes with HRE show higher LV mass than athletes without HRE |
| Malek et al. [38] | 30 | SBP ≥210 mmHg DBP ≥90 mmHg or increase of DBP more than 10 mmHg above resting values | 40.9 ± 6.6 | 100 | Exercise test on treadmill | Ultra-marathon runners | Cross-sectional | Athletes with high-normal BP showed higher interventricular septal thickness and higher left and right ventricular mass index. Combined with HRE these findings were more pronounced. Athletes with isolated HRE did not show LV hypertrophy |
| Tahir et al. [39] | 83 | SBP ≥214 mmHg | 43 ± 10 | 65 | Progressive maximal aerobic exercise test (RAMP); increase in workload of 20–40 W/min | Triathletes | Cross-sectional | In male triathletes, higher maximal SBP values during exercise and longer race distances in swimming and cycling were independent predictors for focal myocardial fibrosis |
| Tahir et al. [40] | 30 | No definition | 45 ± 10 | 100 | Post-race examinations | Triathletes | Cross-sectional | Triathletes with myocardial fibrosis had elevated post-race NT-proBNP levels, higher peak systolic HRE and lower post-race LA ejection fraction |
| Bauer et al. [41] | 142 | No definition | 26 ± 5 | 100 | Progressive maximal aerobic cycling ergometer test; increase in workload of 50 W every 2 min | Handball and ice hockey players | Cross-sectional | Athletes with the lowest SBP/MET slope had the lowest maximum SBP but achieved the highest absolute and relative workload |
| Caselli et al. [14] | 141 | SBP ≥220 mmHg for male, 200 mmHg for female, DBP ≥85 mmHg for male, ≥80 mmHg for female | 26 ± 6 | 66 | Symptom-limited bicycle testing; increase in workload of 0.5 W/kg every 2 min | Endurance, power and mixed disciplines | Prospective (6.5 ± 2.8) | Athletes with HRE had 3.6 times higher risk of developing hypertension compared to those with normal BP response to exercise. No cardiac remodeling during follow up was found |
| Kim et al. [42] | 17 | SBP ≥210 mmHg | 51.7 ± 7.7 | 100 | Bruce protocol | Amateur marathon runners | Case-control | Marathon runners with HRE showed a greater LVMI and had more LV diastolic dysfunction than hypertensive sedentary subjects |
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