Aerobic Training Attenuates Differences Between Black and White Adults in Left Ventricular–Vascular Coupling and Wasted Pressure Effort

Background Black compared with White adults have a higher risk for left‐ventricular hypertrophy and heart failure possibly due to the early onset of alterations in ventricular–vascular coupling (ie, arterial [ E a ] to ventricular elastance [ E es ] ratio) and wasted pressure effort ( E w ). Aerobic training preserves the coupling ratio ( E a / E es ) and attenuates E w , but whether this applies to Black adults is unknown. We hypothesized that Black rather than White adults would have greater training‐induced improvements in the E a / E es and E w . Methods and Results Fifty‐four young adults with normal blood pressure (Black=24 [58% female]; White=30 [47% female], mean=24 years; SD=5 years) completed an 8‐week aerobic training (3 times/week, 65%–85% peak oxygen uptake). E a / E es was estimated via echocardiography and scaled to body surface area, and the E w was estimated from pulse contour analysis. Black adults had lower E a / E es (difference ( d )=0.49 [95% CI, 0.14–0.84 mm Hg/mL], P =0.007) and higher E w ( d =1127 [95% CI, 104–2007 dyne cm −2 s], P =0.005). Both groups exhibited similar (race‐by‐training interaction, P =0.986) training‐induced reductions in scaled E a ( d =−0.11 [95% CI, −0.18 to −0.04 mm Hg/mL], P <0.001). Only in White adults, scaled E es increased ( d white =0.39 [95% CI, 0.11–0.32 mm Hg/mL], P =0.003) and E a / E es was reduced ( d white =−0.16 [95% CI, −0.33 to −0.18 mm Hg/mL/m 2 ], P <0.001). Conversely, only Black adults exhibited reductions in E w after training ( d black =−699 [95% CI, −1209 to −189 dyne cm −2 s], P =0.008). Conclusions Aerobic training‐induced differential effects on E a / E es and E w of White and Black young adults hold the potential to reduce racial disparities. This warrants confirmation in a larger sample. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01024634.