Key result
Hypertension complicated by left ventricular hypertrophy or coronary heart disease was associated with shortened exercise duration and a 3- to 7-fold increase in S-T segment depression.
Why the study?
Does the presence and severity of hypertensive cardiovascular disease impair maximal exercise performance compared to normotensive controls?
Observational (n=61)
Does the presence and severity of hypertensive cardiovascular disease impair maximal exercise performance compared to normotensive controls?
Hypertensive cardiovascular disease, particularly when complicated by LVH, retinopathy, or CHD, significantly impairs maximal exercise performance and increases the prevalence of exercise-induced myocardial ischemia.
Answers are grounded in this paper and cite their sources.
May confound exercise test interpretation in complicated hypertension; leaves open causal mechanisms and prospective outcome validation.
Responses to a multistage treadmill test of maximal exercise were studied in 61 hypertensive patients: 13 had uncomplicated hypertension; 15 had associated retinopathy; 22 had left ventricular hypertrophy; and 11 also had coronary heart disease. Because of significant differences with aging normally, and differences in ages of these subgroups, responses were compared with those of normotensive persons matched for age and sex. With only elevated blood pressure there was no impairment of exercise performance and no increase in S-T segment depression. With ventricular hypertrophy and particularly with retinopathy, maximal exercise duration was shortened. Prevalence of postexertional myocardial ischemia, manifested by S-T segment depression, was increased threefold in those with hypertrophy of the left ventricle. Even greater impairment of exercise duration, maximal heart rate, and systolic pressure was observed in patients with coronary heart disease and hypertension. Prevalence of S-T segment depression was sevenfold greater. This ECG manifestation of myocardial ischemia may represent either an augmented contractile force or a significantly restricted coronary blood supply to limit myocardial perfusion. Differences in duration of exercise and circulatory responses, particularly the product of maximal heart rate and maximal systolic pressure/100, indicate these variations in pathophysiological mechanisms.
No takes yet. Share an insight, caveat, or question.
WONG et al. (1969) conducted an observational in Hypertensive Cardiovascular Disease (n=61). Hypertension and its complications (retinopathy, LVH, CHD) vs. Normotensive persons matched for age and sex was evaluated on Maximal exercise performance and postexertional myocardial ischemia (S-T segment depression). Hypertension complicated by left ventricular hypertrophy or coronary heart disease was associated with shortened exercise duration and a 3- to 7-fold increase in S-T segment depression.
Synapse has enriched 10 related papers. Consider them for comparative context: