Tanaka S, et al. - Researchers investigated if new-onset left ventricular hypertrophy (LVH) in hypertensive patients is linked to excessive SBP elevation during moderate exercise. They found that excessive SBP elevation during moderate exercise in these patients could allow detection of patients at high risk of developing LVH.

Methods

• This study included a total of 143 hypertensive patients without LVH whose BP had been maintained below 140/90 mmHg with antihypertensives.
• These patients were asked to perform cycle ergometer exercise test at moderate intensity to assess SBP elevation during exercise (ΔSBP).
• New-onset LVH was identified by assessing left ventricular mass index (LVMI) by echocardiography once a year.
• Based on tertiles of ΔSBP, patients were divided into three groups.
• Using the Kaplan–Meier method, log-rank test, and Cox regression analysis, researchers assessed the links between ΔSBP and new-onset LVH.

Results

• Resting BP of 126 ± 16/75 ± 11 mmHg was seen in patients (100 men, 65.3 ± 9.1 years).
• Within a follow-up period of 2.5 ± 1.6 years, 47 patients (32.9%) developed new-onset LVH.
• Higher ΔSBP was found to be significantly related to higher incidence of LVH (P < 0.001): 12.8, 27.1, and 58.3% in the lowest, middle, and highest tertiles, respectively.
• ΔSBP was identified as a significant independent determinant of new-onset LVH in multivariate analysis (hazard ratio for 10 mmHg increase in ΔSBP, 1.45; 95% CI 1.22–1.73; P < 0.001).
• The hazard ratios of the middle and highest tertiles for incidence of LVH, vs the lowest tertile, were 3.16 (95% CI 1.07–9.32) and 6.43 (95% CI 2.35–17.62), respectively.