Exercise systolic blood pressure: A powerful determinant of increased left ventricular mass in patients with hypertension

• Published in: Journal of the American College of Cardiology 1985-05, Vol.5 (5), p.1224-1231
• Main Authors: Ren, Jian-Fang, Hakki, A-Hamid, Kotler, Morris N., Iskandrian, Abdulmassih S.
• Format: Article
• Language: English
• Subjects: Adult; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiomegaly - etiology; Cardiomegaly - pathology; Cardiomegaly - physiopathology; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Echocardiography; Exercise Test; Female; Heart Ventricles - pathology; Humans; Hypertension - complications; Hypertension - pathology; Hypertension - physiopathology; Male; Medical sciences; Middle Aged; Systole
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(85)80029-2

This study examines the relation between left ventricular mass determined by two-dimensional echocardiography and exercise blood pressure in patients with hypertension. Sixty-seven patients with hypertension and 19 normal subjects underwent treadmill exercise testing and two-dimensional echocardiography. The left ventricular mass index in the normal subjects was 80 ± 10 g/m2(mean ± SD). Patients with hypertension were classified into two groups according to left ventricular mass: Group I (n = 42) had normal mass and Group II (n = 25) had increased mass (>2 SD above the mean value in 19 normal subjects). There was a poor correlation between left ventricular mass and blood pressure at rest. However, a better correlation was found between left ventricular mass and exercise systolic blood pressure (r = 0.58, p < 0.001) or the change in systolic blood pressure from rest to exercise (r = 0.48, p < 0.001). Twenty-two (76%) of 29 patients with an exercise systolic blood pressure of 190 mm Hg or greater had an increased left ventricular mass index, whereas only 3 (8%) of 38 patients with an exercise systolic blood pressure of less than 190 mm Hg had an increased left ventricular mass index (p < 0.0001). Thus, in patients with hypertension, left ventricular mass index is poorly related to blood pressure at rest, but is related to exercise systolic blood pressure. Patients with an exercise systolic blood pressure of 190 mm Hg or greater usually have an increased left ventricular mass. These findings may have therapeutic implications.