Abstract
We investigated the clinical implications of blood pressure changes after 20min of rest and during exercise in particular for predicting the progression of left ventricular hypertrophy (LVH) in unmedicated male subjects with borderline and mild hypertension. We studied 155 subjects who were enrolled in a hypertension management program that included routine annual physical check-ups and cardiovascular follow-up studies, including echocardiography and treadmill exercise stress testing, every 3 years. Sixty-nine subjects were followed for 5 years without pharmacological intervention. Left ventricular mass index (LVMI) was correlated with systolic pressure at peak exercise (max Ps) and 20-min resting systolic pressure in 155 subjects. Stepwise multiple linear regression analysis showed that the initial LVMI and max Ps had significantly higher percent explained variances in relation to the LVMI increase over the 5-year observation period compared with other variables. Hyper-responders, subjects with an initial max Ps above 200mmHg, showed a greater increase in LVMI than subjects with an initial max Ps below 200mmHg, although there was a small but significant increase in LVMI, without any increase in the blood pressure variables, even in those showing a normal response. In conclusion, max Ps appears to be a simple and reliable predictor of LVH progression. (Hypertens Res 1992; 15: 155-161)
