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January 1, 1998Hypertension ResearchOpen Access

The percentage change in the peak velocity of early filling (E) after exercise was significantly greater in obese hypertensive patients than in non-obese hypertensive patients and normotensive controls (23+/-4% vs. 12+/-3% and 14+/-3%, p < 0.05).

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Why the study?

Does mild to moderate obesity worsen left ventricular diastolic filling at rest or during exercise in hypertensive patients?

Population

57 adults, comprising 19 obese hypertensive patients with normal left ventricular structure, 19 age- and…

Comparison

Dynamic submaximal exercise on a supine… vs Non-obese hypertensive patients and non-obese…

Design

Cross-sectional, Echocardiograms analyzed by 3 experienced echocardiographers…

Authors

SSShinji SetoGKGaston KapukuFKFumitaka Kawahara

Discussion

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Member takes

Overview

Does not support avoiding mild obesity for diastolic concerns in hypertension; leaves open effects on outcomes and needs prospective validation.

Structured PICO

Does mild to moderate obesity worsen left ventricular diastolic filling at rest or during exercise in hypertensive patients?

P
Population
57 adults (mean age 55+/-3 years), comprising 19 obese hypertensive patients (BMI 26-30 kg/m2) with normal left ventricular structure, 19 age- and sex-matched non-obese hypertensive patients, and 19 age- and sex-matched non-obese normotensive controls. Conducted in Japan.
I
Intervention
Dynamic submaximal exercise on a supine ergometer bicycle (workload started at 25 W and increased by 25 W every 3 min until a maximum of 75 W)
C
Comparator
Non-obese hypertensive patients and non-obese normotensive controls undergoing the identical exercise protocol
O
Outcome
Percentage change in peak velocity of early filling (E), late filling (A), and their ratio (E/A) from rest to 1 min after exercise, measured by pulsed Doppler echocardiographysurrogate

Mild to moderate obesity does not worsen resting left ventricular diastolic filling in hypertensive patients and appears to mitigate diastolic filling abnormalities during exercise.

Limitations

  • Exclusion of obese patients with cardiac structural changes limits generalizability to that subgroup
  • Did not measure plasma catecholamines to assess sympathetic response
  • Lack of concomitant monitoring of intracardiac pressure and cardiac output

Cite This Study

Seto et al. (1998) studied this question.

synapsesocial.com/papers/6a226f0b8a4701dbb79117b4https://doi.org/10.1291/hypres.21.245
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Ventricular Filling in Arterial Hypertension1997 · 63 citations
  2. 2Obesity influences left ventricular filling in essential hypertension.1995
  3. 3Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity1991 · 103 citations
  4. 4Doppler Assessment of the Effects of Isometric Stress on Left Ventricular Filling in Hypertensive Young Adults1989 · 2 citations
  5. 5Influence of Obesity on Left Ventricular Midwall Mechanics in Arterial Hypertension1996 · 54 citations