H. Tomiyama et al., PROSPECTIVE STUDIES ON LEFT-VENTRICULAR GEOMETRIC PATTERNS AND EXERCISE TOLERANCE IN UNMEDICATED MEN WITH BORDERLINE AND MILD HYPERTENSION, Journal of hypertension, 14(10), 1996, pp. 1223-1228
Objective This study was designed and conducted to assess the clinical
significance of left ventricular geometric patterns and physical fitn
ess in subjects with untreated borderline and mild hypertension. Metho
ds Symptom-limited maximal treadmill stress testings and echocardiogra
phic examinations were administered to 192 previously unmedicated men.
Left ventricular geometric patterns were determined by the combined c
riteria of left ventricular mass index and relative wall thickness. Su
bjects whose left ventricular mass index was <125 g/m(2) were followed
up for more than 3 years. Results Normalized treadmill time was lower
and pressure rate products at peak exercise were higher in patients w
ith concentric hypertrophy than in those with normal geometry, Of the
77 patients who revealed left ventricular mass index at baseline <125
g/m(2) and who were successfully followed without medication for more
than 3 years, 18 demonstrated concentric hypertrophy at the final foll
ow-up examination, During the follow-up period, these 18 patients had
significant further augmentation of concentric geometric features, sig
nificant decreases in both cardiac output and normalized treadmill tim
e, and significant increases in casual blood pressure and total periph
eral resistance compared with those at baseline. Conclusion Patients w
ith concentric hypertrophy exhibited slightly but significantly impair
ed levels of physical fitness and cardiac work efficiency, and the pro
gression of concentric hypertrophy demonstrated further impairments of
these conditions, Therefore, not only lowering blood pressure, but al
so improving left ventricular hypertrophy, cardiovascular hemodynamics
, and physical fitness might be required in patients with concentric h
ypertrophy.