![]() ![]() Physicians need to be aware of the effects of various medications on exercise tolerance and the rules for participation established by sports regulatory bodies ![]() If the target blood pressure is not achieved, the medication dosage may be adjusted, or a second medication, usually a diuretic, may be added. If excellent control is maintained for six to 12 months, medication may be reduced or withdrawn in a small number of patients. When the target blood pressure is achieved, long-term follow-up care and management should be emphasized. If beta blockade is needed, a combined alpha-beta blocker may be the best choice. A thiazide diuretic may be used as first-line treatment for hypertension in casually active patients however, diuretic therapy is less desirable in high-intensity or endurance athletes because of the risk of hypovolemia or hypokalemia. If control is inadequate, low-dose therapy with an angiotensin-converting enzyme inhibitor or a calcium channel blocker may be started. If blood pressure control is adequate, lifestyle modifications are continued. ![]() Mild hypertension should be treated with nonpharmacologic measures for six months. Athletes and other physically active patients should be screened for hypertension and given appropriate therapy if needed. ![]()
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