This study indicates that the blood pressure reducing effect of exercise in essential hypertension is intensity dependent. Aerobic interval training is an effective method to lower blood pressure and improve other cardiovascular risk factors.
Background
Left atrial (
LA
) size and cardiorespiratory fitness (
CRF
) are predictors of future cardiovascular events in high‐risk populations.
LA
dilatation is a diagnostic criterion for left ventricular diastolic dysfunction. However,
LA
is dilated in endurance athletes with high
CRF
, but little is known about the association between
CRF
and
LA
size in healthy, free‐living individuals. We hypothesized that in a healthy population,
LA
size was associated with
CRF
and leisure‐time physical activity, but not with echocardiographic indexes of left ventricular diastolic dysfunction.
Methods and Results
In this cross‐sectional study from HUNT (Nord‐Trøndelag Health Study), 107 men and 138 women, aged 20 to 82 years, without hypertension, cardiovascular, pulmonary, or malignant disease participated.
LA
volume was assessed by echocardiography and indexed to body surface area LAVI (left atrial volume index).
CRF
was measured as peak oxygen uptake (
VO
2peak
) using ergospirometry, and percent of age‐ and‐sex‐predicted
VO
2peak
was calculated. Indexes of left ventricular diastolic dysfunction were assessed in accordance with latest recommendations.
LAVI
was >34 mL/m
2
in 39% of participants, and
LAVI
was positively associated with
VO
2peak
and percentage of age‐ and‐sex‐predicted
VO
2peak
(β (95% CI) 0.18 (0.09‐0.28) and 0.10 (0.05‐0.15)), respectively) weighted minutes of physical activity per week (β [95%
CI
], 0.01 [0.003–0.015]).
LAVI
was not associated with other indexes of left ventricular diastolic dysfunction. There was an effect modification between age and
VO
2peak
/percentage of age‐ and‐sex‐predicted
VO
2peak
showing higher
LAVI
with advanced age and higher
VO
2peak
/percentage of age‐ and‐sex‐predicted
VO
2peak
as presented in prediction diagrams.
Conclusions
Interpretation of
LAVI
as a marker of diastolic dysfunction should be done in relation to age‐relative
CRF
. Studies on the prognostic value of
LAVI
in fit subpopulations are needed.
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