Cardiologia Croatica. 2026;21(3-4)

Nóra Homoródi, Andrea Szegedi, Tímea Bianka Papp, Szabolcs Gergely, Zoltán Csanádi

During the rehabilitation process, the question of recreational activities typically arises in the convalescent phase. Recreation encompasses physical and/or mental activities that fulfill a psychologically and biologically determined need. Tourism includes both physical and mental recreational elements. Regarding distant destinations, air travel raises several concerns, just as domestic tourism frequently involves visits to spas and saunas, both of which may pose risks for patients with cardiovascular conditions. Air travel exposes passengers to physical, psychological, and physiological effects, which can lead to cardiac symptoms, most commonly palpitations and chest pain. Visiting thermal baths and saunas is a popular recreational activity, but it can also be concerning for patients with cardiovascular disease. The degree of temperature elevation and its impact on circulation differ between baths and saunas, making them not universally recommended for these patients. In this review, we summarize the physiological effects of air travel on the human body, as well as international literature and guidelines regarding air travel in various cardiovascular conditions. Furthermore, we detail the circulatory changes induced by Finnish and infrared saunas, as well as hot water baths, and discuss their potential contraindications.

Zsolt Szelid, Ágnes Sziva

This summary article reviews the complex relationship between hypertension and sports, addressing key aspects of prevalence, risk factors, and management strategies. Hypertension is a leading cause of cardiovascular disease and mortality, and while regular exercise generally provides cardioprotective effects, certain sports disciplines and lifestyle choices may elevate blood pressure (BP) levels in athletes. The article highlights the role of isometric training, high body mass, and the use of performance-enhancing substances as contributors to increased risk. Additionally, it explores the implications of high BP on both athletic performance and long-term cardiovascular health in physically active patients. Diagnostic challenges are discussed, emphasizing the limitations of routine measurements and the need for advanced tools such as ambulatory BP monitoring. Updated European guidelines are presented as a framework for accurate hypertension diagnosis and risk assessment among athletes. Management approaches prioritize lifestyle interventions, including dietary changes, stress reduction, and tailored exercise programs. When necessary, pharmacological treatments are recommended with careful consideration of doping regulations and potential impacts on athletic performance. This article underscores the importance of individualized care in addressing hypertension in athletes, advocating for a multidisciplinary approach that integrates medical, nutritional, and training expertise. By consolidating current evidence, the article aims to provide practical guidance for clinicians, treating athletes and patients with regular physical activities, to better understand and manage hypertension in this population.

Timur Mušić, Marko Radolović, Amela Kabaklić

The autonomic nervous system (ANS) plays a pivotal role in cardiovascular (CV) regulation through the dynamic interplay of its sympathetic and parasympathetic divisions. Dysregulation of autonomic balance is increasingly recognized as an important pathophysiological contributor to a broad range of CV disorders. A variety of non-invasive methods, such as heart rate variability, heart rate recovery, baroreflex sensitivity, blood pressure monitoring, and tilt-table testing, have demonstrated substantial diagnostic and prognostic value in assessing autonomic function across CV disorders, while complementary procedures such as the active standing test, Valsalva maneuver, and deep-breathing test may offer additional insight on autonomic control but remain underutilized in routine cardiology. Despite growing evidence supporting their clinical relevance, the broader clinical adoption of ANS testing remains limited by methodological heterogeneity, absence of unified standards, and insufficient consensus on interpretation and clinical decision pathways. This article provides an integrated overview of commonly used ANS testing modalities, summarizing their physiological basis and evaluating their clinical applicability in cardiology. In addition to technological advances, establishing unified international guidelines, standardized protocols, and consensus-based interpretation frameworks will be crucial to ensure consistency, improve comparability between studies, and facilitate the integration of ANS testing into routine cardiological practice. Through such collaborative efforts, ANS assessment has the potential to evolve from a research instrument into a component of personalized CV medicine.