Exercise capacity and blood pressure associations with left ventricular mass in prehypertensive individuals
Open accessAbstract
Prehypertensive individuals are at increased risk for developing hypertension and cardiovascular disease compared with those with normal blood pressure. Early compromises in left ventricular structure may explain part of the increased risk. We assessed echocardiographic and exercise parameters in prehypertensive individuals (n=790) to determine associations between exercise blood pressure and left ventricular structure. The exercise systolic blood pressure at 5 metabolic equivalents (METs) and the change in blood pressure from rest to 5 METs were the strongest predictors of left ventricular hypertrophy. We identified the systolic blood pressure of 150 mm Hg at the exercise levels of 5 METs as the threshold for left ventricular hypertrophy. There was a 4-fold increase in the likelihood for left ventricular hypertrophy for every 10-mm Hg increment in systolic blood pressure beyond this threshold (OR: 1.15; 95% CI: 1.12 to 1.18). There was also a 42% reduction in the risk for left ventricular hypertrophy for every 1 MET increase in the workload (OR: 0.58; P<0.001). When compared with low-fit, moderate, and high-fit individuals exhibited significantly lower systolic blood pressure at an exercise workload of 5 METs (155+/-14 versus 146+/-10 versus 144+/-10; P<0.05), lower left ventricular mass index (48+/-12 versus 41+/-10 versus 41+/-9; P<0.05), and prevalence of left ventricular hypertrophy (48.3% versus 18.7% versus 21.6%; P<0.001). This suggests that moderate improvements in cardiorespiratory fitness achieved by moderate intensity physical activity can improve hemodynamics and cardiac performance in prehypertensive individuals and reduce the work of the left ventricle, ultimately resulting in lower left ventricular mass.
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Exaggerated exercise blood pressure (EEBP) recorded during clinical exercise testing is independently associated with blood pressure-related cardiovascular disease (CVD) outcomes.
“Exaggerated exercise blood pressure recorded during clinical exercise testing is independently associated with blood pressure -related cardiovascular disease outcomes”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [13]
The LVH Predictors section (page unavailable) reports that exercise systolic blood pressure was associated with left ventricular hypertrophy after adjustment for resting blood pressure, BMI, and age. This supports an independent association in prehypertensive individuals, but the study assessed left ventricular structure, not cardiovascular disease outcomes more broadly. (LLM, conf=0.87)
Experimental — accuracy not yet measuredFor a given fixed submaximal workload, individuals with greater cardiorespiratory fitness have lower exercise SBP.
“When a workload is fixed at submaximal exercise intensity, individuals with greater cardiorespiratory fitness have lower exercise BP.”
From Cardiorespiratory Fitness, Workload, and the Blood Pressure Response to Exercise Testing (2022) · cites this paper as [13]
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 [35]
Exercise systolic BP values beyond as little as 150 mmHg during moderate intensity exercise are associated with the presence of hypertension (confirmed by ambulatory BP monitoring) and risk of left ventricular hypertrophy.
“Some studies have shown exercise systolic BP values beyond as little as 150 mmHg during moderate intensity exercise to be associated with the presence of hypertension (confirmed by ambulatory BP monitoring) [10] and risk of left ventricular hypertrophy [35].”
From The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance (2022) · cites this paper as [35]
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References 35 · Cited by 111
Research works printed but not linked: 5
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- Bikkina M, Levy D, Evans JC, Larson MG, Benjamin EJ, Wolf PA, Castelli WP. Left ventricular mass and risk of stroke in an elderly cohort. JAMA. 1994;272:33-36.
- Kokkinos P, Narayan P. Colleran J, Pittaras A, Notargiacomo A, Reda D, Papademetriou V. Effects of exercise on blood pressure and left ventric- ular hypertrophy in African-Americans with severe hypertension. N Engl J Med. 1995;333:1462-1467.
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- Authors
- Kokkinos, P., Pittaras, A., Narayan, P., Faselis, C., Singh, S., & Manolis, A.
- Affiliations
- Georgetown University (US)
- Venue
- Hypertension
- Published
- 2007-01
- Volume
- 49
- Issue
- 1
- Pages
- 55-61
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2111036429
- Cited by
- 111
- References
- 35
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 9 · 2021: 15 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 4 · 2012: 2
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- prehypertension, left ventricular hypertrophy, left ventricular mass, blood pressure response to exercise, cardiorespiratory fitness, exercise capacity, physical activity, cardiovascular risk
- MeSH terms
- Adult, Blood Pressure, Differential Threshold, Echocardiography, Female, Heart Ventricles, Humans, Hypertension, Male, Middle Aged, Physical Endurance, Physical Fitness, Predictive Value of Tests, Systole, Exercise, Likelihood Functions, Hypertrophy, Left Ventricular, Risk Assessment
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