Hypertensive response to exercise in normotensive patients with hypertrophic cardiomyopathy was not associated with a higher risk of future progression to hypertension or adverse cardiovascular events.
Cohort (n=333)
No
Does a hypertensive response to exercise predict future hypertension or adverse cardiovascular outcomes in normotensive patients with hypertrophic cardiomyopathy?
In normotensive patients with hypertrophic cardiomyopathy, a hypertensive response to exercise is common but does not increase the risk of future hypertension or adverse cardiovascular outcomes.
Absolute Event Rate: 8% vs 9%
p-value: p=0.9
Objective: Hypertensive response to exercise (HRE) is observed in patients with hypertrophic cardiomyopathy (HCM) with normal resting blood pressure (BP). However, the prevalence or prognostic implications of HRE in HCM remain unclear. Methods: In this study, normotensive HCM subjects were enrolled. HRE was defined as systolic BP > 210 mmHg in men or >190 mmHg in women, or diastolic BP > 90 mmHg, or an increase in diastolic BP > 10 mmHg during treadmill exercise. All participants were followed for subsequent development of hypertension, atrial fibrillation (AF), heart failure (HF), sustained ventricular tachycardia/fibrillation (VT/VF), and all-cause death. Six hundred and eighty HCM patients were screened. Results: 347 patients had baseline hypertension, and 333 patients were baseline normotensive. 132 (40%) of the 333 patients had HRE. HRE was associated with female sex, lower body mass index and milder left ventricular outflow tract obstruction. Exercise duration and metabolic equivalents were similar between patients with or without HRE, but the HRE group had higher peak heart rate (HR), better chronotropic response and more rapid HR recovery. Conversely, non-HRE patients were more likely to exhibit chronotropic incompetence and hypotensive response to exercise. After a mean follow-up of 3.4 years, patients with and without HRE had similar risks of progression to hypertension, AF, HF, sustained VT/VF or death. Conclusion: HRE is common in normotensive HCM patients during exercise. HRE did not carry higher risks of future hypertension or cardiovascular adverse outcomes. Conversely, the absence of HRE was associated with chronotropic incompetence and hypotensive response to exercise.
Lu et al. (Fri,) conducted a cohort in Hypertrophic cardiomyopathy with normal resting blood pressure (n=333). Hypertensive response to exercise (HRE) vs. No hypertensive response to exercise was evaluated on Progression to hypertension (p=0.9). Hypertensive response to exercise in normotensive patients with hypertrophic cardiomyopathy was not associated with a higher risk of future progression to hypertension or adverse cardiovascular events.