Children and adolescents are encouraged to engage in non-competitive physical activity to reduce the risk of hypertension. Individuals with hypertension, the most common cardiovascular condition seen in competitive athletes, can suffer complications when exercise causes their blood pressure to rise too high. In a new policy statement from the American Academy of Pediatrics (AAP), “Athletic Participation by Children and Adolescents Who Have Systemic Hypertension,” published in the June issue of Pediatrics (appearing online May 31), the recommendations concerning the athletic participation of those with hypertension are updated to include populations especially at risk, including obese athletes and individuals with spinal cord injuries. Other recommendations, including lifestyle modifications that include daily exercise and a well-balanced diet, should be discussed at all well-child visits. Patients with prehypertension should have their blood pressure measured every 6 months, and medication, caffeine, alcohol, tobacco, and stimulant use should be monitored because of the effects these substances can have on blood pressure. Many athletes with hypertension may be competitive, as long as they are properly monitored and adopt healthy behaviors into their daily routine.