Physical activity is an important component of ideal cardiovascular health. Current guidelines recommend that youth with hypertension participate in competitive sports once hypertensive target organ effects and risks have been assessed and that children with hypertension receive treatment to lower BP below stage 2 thresholds (e.g., < 140/90 mmHg or < 95th percentile + 12 mmHg) before participating in competitive sports. Despite these recommendations, pediatricians and pediatric subspecialists continue to struggle with how best to counsel their patients regarding appropriate forms of physical activity, the impact of exercise on blood pressure, and how best to screen for cardiovascular conditions that place youth at risk for sudden cardiac death. This review provides a summary of our current knowledge regarding the safety and utility of exercise in the management of high blood pressure in youth. We review determinants of blood pressure during exercise, the impact of blood pressure on cardiovascular health and structure, mechanisms for assessing cardiometabolic fitness (e.g., exercise stress test), contraindications to athletic participation, and how best to plan for athletic participation among hypertensive youth. Greater knowledge in these areas may offer clarity to providers faced with the challenge of prescribing exercise recommendations for hypertensive youth.

中文翻译：

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建议进行运动和筛查，以确保高血压青年能安全参加运动。

体育锻炼是理想的心血管健康的重要组成部分。当前的指南建议，一旦评估了高血压目标器官的作用和风险，患有高血压的青年就应参加竞技运动，并建议高血压儿童接受将血压降低至低于第2阶段阈值的治疗（例如，<140/90 mmHg或<95％百分位数+ 12 mmHg ）参加竞技运动。尽管有这些建议，儿科医生和儿科专科医生仍在努力如何就适当的体育活动，锻炼对血压的影响以及如何最好地筛查可能使年轻人处于心脏猝死危险中的心血管疾病的状况向患者提供咨询的最佳方法。这篇综述总结了我们目前有关锻炼在管理高血压中的安全性和实用性方面的知识。我们回顾了运动中血压的决定因素，血压对心血管健康和结构的影响，评估心脏代谢适应性的机制（例如运动压力测试），运动参与的禁忌症以及如何最好地计划高血压青年中的运动参与。在这些领域的更多知识可能使面临着为高血压青年开出运动建议处方的挑战的提供者更加清楚。评估心血管代谢适应性的机制（例如运动压力测试），运动参与的禁忌症以及如何最好地计划高血压青年的运动参与。在这些领域的更多知识可能使面临着为高血压青年开出运动建议处方的挑战的提供者更加清楚。评估心血管代谢适应性的机制（例如运动压力测试），运动参与的禁忌症以及如何最好地计划高血压青年的运动参与。在这些领域的更多知识可能使面临着为高血压青年开出运动建议处方的挑战的提供者更加清楚。