Patients with a hypertensive response to exercise have impaired systolic function without diastolic dysfunction or left ventricular hypertrophy
Open accessAbstract
Objectives We sought to determine if a hypertensive response to exercise (HRE) is associated with myocardial changes consistent with early hypertensive heart disease.Background An HRE predicts the development of chronic hypertension (HT) and may reflect a preclinical stage of HT.Methods Patients with a normal left ventricular (LV) ejection fraction and a negative stress test were recruited into three matched groups: 41 patients (age 56 +/- 10 years) with HRE (>210/105 mm Hg in men; >190/105 in women), comprising 22 patients with (HT+) and 19 without resting hypertension (HT-); and 17 matched control subjects without HRE. Long-axis function was determined by measurement of the strain rate (SR), peak systolic strain, and cyclic variation (CV) of integrated backscatter in three apical views.Results An HRE was not associated with significant differences in LV mass index. Exercise performance and diastolic function were reduced in HRE(HT+) patients, but similar in HRE(HT-) patients and controls. Systolic dysfunction (peak systolic strain, SR, and CV) was significantly reduced in HRE patients (p < 0.001 for all). These reductions were equally apparent in patients with and without a history of resting HT (p = NS) and were independent of LV mass index and blood pressure (p < 0.01).Conclusions An HRE is associated with subtle systolic dysfunction, even in the absence of resting HT. These changes occur before the development of LV hypertrophy or detectable diastolic dysfunction and likely represent early hypertensive heart disease.
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Several studies have shown relationships between EEBP and adverse cardiac structure and function, indicative of hypertensive heart disease.
“Several studies have also shown relationships between EEBP and adverse cardiac structure [33,34,35,36] and function [37], indicative of hypertensive heart disease.”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [37]
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Evaluation of Left Atrial Function with Strain Imaging: Is it Ready for "Prime Time"?
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Haemodynamics and biochemistry of a hypertensive response to exercise
Nikolic, S. N. (2004) · UTAS Research Repository · doi:10.25959/23241593
Triantafyllou, K. A., Kranidis, A. I., Koulouris, S. N., Tzeis, S. E., & Manolis, A. S. (2005) · PubMed
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Hypertensive Response to Exercise Linked with Subtly Impaired Systolic Function
Fleischmann, K. E. (2004) · Journal watch · doi:10.1056/jw200404270000006
Hypertensive Response to Exercise Linked with Early Hypertensive Heart Disease
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空気を読みすぎることが問題なのではない (特集 空気読めない子・読みすぎる子)
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Research Status of Hypertensive Response to Exercise
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- Authors
- Mottram, P. M., Haluska, B., Yuda, S., Leano, R., & Marwick, T. H.
- Affiliations
- The University of Queensland (AU)
- Corresponding author
- Marwick, Thomas H.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 43
- Issue
- 5
- Pages
- 848-853
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2023721696
- Cited by
- 85
- References
- 27
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 8 · 2016: 4 · 2014: 4 · 2013: 5 · 2012: 1
- FWCI
- 4.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertensive response to exercise, systolic dysfunction, hypertensive heart disease, left ventricular hypertrophy, diastolic dysfunction, strain rate imaging, integrated backscatter, left ventricular mass, exercise-induced hypertension
- MeSH terms
- Female, Humans, Hypertension, Male, Middle Aged, Myocardial Contraction, Exercise, Hypertrophy, Left Ventricular
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