Although an athlete is routinely exposed to rigorous physical training programs leading to improved cardiorespiratory function, more recently, there has been concern with athletes presenting with hemodynamic abnormalities commonly associated with morbidity and mortality within the general population. PURPOSE: To quantify blood pressure (BP) abnormalities among NCAA Division I and II collegiate athletes. METHODS: Following written informed consent, 217 (131 male, 86 female) athletes (mean ± SEM; age = 20.0 ± 0.1 yr; ht = 178.7 ± 1.1 cm; wt = 86.9 ± 1.8 kg) underwent supine, hyperventilation, and standing BPs using a manual, hand-held sphygmomanometer as part of a preexercise evaluation prior to CPET. Supine BPs were subsequently evaluated using ACC/AHA criteria, with data analyzed by gender and race (50 African American, 167 White). RESULTS: MANOVAs (Wilks’ λ )indicated a significant main effect across gender (F2,214 = 14.987; P < 0.0001), but not race (F2,214 = 2.239; P = 0.101). Post hoc analyses revealed that, overall, males exhibited a higher incidence of elevated BP (BPsys 121.2±0.9 vs. 113.8±1.1; BPdias 70.1±0.9 vs 74.4 ±0.7, p < 0.0001) than females, respectively. Among the 45.6% of total athletes diagnosed with elevated BP, 74.7% were males (BPsys 124.9±0.7/BPdias 77.8±0.7) as compared to 25.3% of cases documented among females (BPsys 122.9±1.2/BPdias 76.9±1.2). Of equal concern, was the hypertension indicated in 7.6% of male athletes (BPsys 142.8±1.9/BPdias 84.0±1.9), with none reported among females. CONCLUSION: Findings indicated that 50.2% of NCAA Division I and II athletes in this study were diagnosed, based on ACC/AHA guidelines, with either elevated BP (BPsys between 120-129 mm Hg and BPdias less than 80 mm Hg) or Stage I or II hypertension (BPsys greater than 129 mm Hg, and BPdias ≥ 80 mm Hg). These findings support the need for early detection, follow-up screening, and non-drug treatment of athletes to include identifying risk factors (i.e., stress) and knowledge assessment. Ongoing studies are underway to assess the breadth and long-term implications of elevated BP on the athletes’ health, particularly with respect to potential cardiovascular risk.