Early impairment of the cardiopulmonary exercise capacity of hypertensive patients

Abstract

A reduction of functional capacity has been reported in severe hypertension. However, the reduced peripheral vasodilation observed in the early stages of hypertension, could also impair the blood supply to exercising muscles in mild hypertensives presenting a normal left ventricular mass. In this paper the cardiopulmonary exercise capacity of early hypertensives has been investigated. Thirty mild hypertensives (9 in stage I and 21 in stage II according to WHO) and 36 normotensives divided into two age and weight-matched groups, were investigated. All subjects underwent a stress test according to the modified Bruce protocol with contemporary assessment of breath-by-breath expiratory gas analysis and measurement of the anaerobic threshold (AT) and of the oxygen consumption at peak exercise (PVO2). Exercise duration and maximal workload, in stage I hypertensives, were similar to controls but the O2 consumption was significantly reduced in comparison to controls (P = 0.043). On the contrary, in stage II patients exercise duration, maximal workload, PVO2 and AT were significantly lower than in normotensives. No relationship between myocardial hypertrophy and ergometric or ventilatory (PVO2, AT, VE) parameters was found. In conclusion an early impairment of the aerobic exercise performance is detectable in uncomplicated (stage I WHO) mild hypertensives.

Candesartan Improves Maximal Exercise Capacity in Hypertensives: Results of a Randomized Placebo‐Controlled Crossover Trial

“…This raises the possibility that hypertensive patients have a limited ability to exhibit a full hemodynamic response to maximal bicycle ergometer exercise. Our data support the results from previous reports of impaired peak VO 2 and reduced exercise capacity in patients with WHO stage I and II hypertension 1 . Our finding that impairment of peak VO 2 , as well as maximal workload, were related to elevated BP and to LV hypertrophy has also been demonstrated by Missault and colleagues 27 in middle‐aged hypertensive men.…”

“…A reduction of functional capacity has been reported in hypertension. However, the reduced peripheral vasodilatation observed in the early stages of hypertension could also impair the blood supply to exercising muscles in mild hypertensive patients who present with a normal left ventricular (LV) mass 1 . Considering that mild hypertension is defined as a systolic blood pressure (BP) 140 to 159 mm Hg and a diastolic BP 90 to 99 mm Hg, respectively, secondary preventive measures are the most widely used at this stage of the disease.…”

Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension

“…Despite the inconsistency in DBP and SBP, our finding of the link between BP and exercise capacity are in accord with the studies in adults ( 22 , 23 ), which showed that the exercise capacity of the hypertensive group was significantly lower than that of the healthy control group. The studies also suggested that the deterioration of exercise capacity in hypertensive patients began long before the alteration of cardiac structure.…”