Relationship between Exercise-induced Blood Pressure Response and Left Ventricular Hypertrophy in Patients with Hypertension

Abstract

Background：In hypertensive patients who show abnormal blood pressure (BP response during exercise, a more excessive blood pressure response may occur in the daily life and cause end organ damage. However, previous studies concerning exaggerated BP response during exercise have been unable to establish its significance and role in left ventricular hypertrophy. The purpose of this study was to determine the relation between exaggerated BP response during exercise and left ventricular hypertrophy. Methods：A treadmill exercise test and echocardiography were performed in 117 patients with hypertension. Sixty-six patients showed normal BP response, and fifty-one patients showed exaggerated BP response. Exaggerated BP response was defined as an elevation of peak exercise systolic BP over 210 mmHg or >10 mmHg elevation of peak exercise diastolic BP from baseline. The correlation between BP response and left ventricular mass index were evaluated in two groups. Results：The results were as follows：1 The peak systolic and diastolic BP were significantly higher in patients with exaggerated BP response than that in patients with normal BP response (p<0.05. 2 There was a weakly significant relation between peak exercise systolic BP and left ventricular hypertrophy, however diastolic BP showed no significant correlation with left ventricular hypertrophy. 3 The left ventricular mass index was significantly increased in patients with exaggerated BP response (normal BP response：120±25 gm/m 2 , exaggerated BP response：169±46 gm/m 2 , p＝0.04. Conclusion：These results indicate that, as compared with resting BP, exercise BP response seems to be important in the treatment of hypertension and more strict blood pressure control may be needed in hypertensive patients with exaggerated BP response. Further study is needed to understand the significance of exaggerated BP response in hypertension.(Korean Circulation J 2001;31(8 :809-814