Arterial Hypertension is a condition involving sustained raised blood pressure. Primary Arterial Hypertension is more common and is characterised by having no obvious cause. Secondary Arterial Hypertension is rare, and is commonly treated by addressing the cause in the first instance.
Status of medication in sport
Beta-blockers (e.g. Atenolol/Propranolol) are prohibited in-competition in the following sports (and also out-of-competition in some instances – refer to the WADA website): archery, automobile, billiards, darts, golf, shooting, skiing/snowboarding and underwater sports.
Most diuretics are prohibited at all times in sport. As a first step, check the ASADA or WADA website to see if the particular medication is prohibited in sport.
It is preferable that a permitted anti-hypertensive medication (e.g. ACE inhibitor) has been trialled prior to a request for the approved use of a prohibited medication. If this is not possible, an explanation should be provided.
What information is required for a Therapeutic Use Exemption (TUE) application?
- A completed TUE application form signed by the treating doctor and athlete.
- Detailed typed clinical letter(s) from treating specialist(s) that includes:
- diagnosis – summary of clinical history leading to diagnosis, including serial blood pressure readings over a period of time
- age of diagnosis and management to date
- thorough clinical examination to confirm diagnosis and exclude other causes
- clinical response to non-WADA prohibited medications and appropriate lifestyle modifications, and
- current treatment, including route of administration, dose and frequency of all medications. Must include failed trials of permitted anti-hypertensives.
NOTE: A clinical letter can be a copy of a specialist’s letter to another doctor (e.g. a GP), and at least one of the clinical letters submitted with the application must have been written in the last 12 months.
- Supplementary reports (if available) that support the diagnosis, including laboratory testing to exclude other conditions such as ECG, echocardiography and renal investigations.
NOTE. Athletes using a threshold substance (e.g. pseudoephedrine or salbutamol) and are in the process of submitting a TUE application for a diuretic, will be required to also submit a TUE application for the threshold substance as the urinary levels may be increased.
For additional information please refer to the medical information relating to the condition on the WADA website.