PHYSICAL PERFORMANCE IS PRESERVED AFTER REGRESSION OF LEFT-VENTRICULAR HYPERTROPHY

Reversal of left ventricular hypertrophy has been shown to improve lef t ventricular diastolic function in elderly patients with hypertension , but little is known about whether this affects physical performance. Left ventricular mass, cardiac function at rest and during submaximal exercise, and physical performance were assessed in 38 elderly patien ts with hypertension with left ventricular hypertrophy and normal syst olic function before and after 8 and 14 months of therapy with amlodip ine or hydrochlorothiazide or both. Blood pressure control was achieve d with amlodipine in 18 patients, with hydrochlorothiazide in seven, a nd with the combination of these drugs in 13. Left ventricular mass in dex was similarly reduced from similar to 150 to similar to 100 g/m(2) at 14 months' in each treatment group. Systolic function was maintain ed with the three treatment regimens, whereas similar decreases in tim e to peak filling rate and increases in first-third filling fraction o ccurred both at rest and during submaximal exercise after 8 months and further after 14 months of therapy. Exercise capacity did not signifi cantly change in the group as a whole, but individual changes in peak oxygen uptake at the end of treatment correlated significantly with th e decrease in time to peak filling rate during submaximal exercise (r = -0.49; p < 0.01). It is concluded that long-term blood pressure cont rol with amlodipine or hydrochlorothiazide or both is associated with significant reductions in left ventricular mass and improved diastolic function in elderly patients with hypertension with left ventricular hypertrophy. Despite this reduction in left ventricular mass, left ven tricular systolic function and physical performance are well preserved during submaximal exercise.