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Effect of Endurance Exercise Training on Left Ventricular Size and Remodeling in Older Adults With Hypertension

^a Division of Geriatrics and Gerontology and the Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri

Ali A. Ehsani, Washington University School of Medicine, 4566 Scott Avenue, Campus Box 8113, St. Louis, MO 63110 E-mail: aehsani{at}imgate.wustl.edu.

Decision Editor: William B. Ershler, MD

Background. It is not known whether exercise training can induce a reduction of blood pressure (BP) and a regression of left ventricular hypertrophy (LVH) in older hypertensive subjects. This study was designed to determine whether endurance exercise training, by lowering BP, can induce regression of LVH and left ventricular (LV) concentric remodeling in older hypertensive adults.

Methods. We studied 11 older adults with mild to moderate hypertension (BP 152.0 ± 2.5/91.3 ± 1.5 mm Hg, mean ± SE), 65.5 ± 1.2 years old, who exercised for 6.8 ± 3.8 months. Seven sedentary hypertensive (BP 153 ± ³/₈₉ ± 2 mm Hg) subjects, 68.5 ± 1 years old, served as controls. LV size and geometry and function were assessed with the use of two-dimensional echocardiography.

Results. Exercise training increased aerobic power by 16% ( p < .001), and it decreased systolic ( p < .05) and diastolic ( p < .05) BP, LV wall thickness (from 12.8 ± 0.4 mm to 11.3 ± 0.3 mm; p < .05), and the wall thickness-to-radius (h/r) ratio (from 0.48 ± 0.02 to 0.41 ± 0.01; p < .05). There were no significant changes in the controls. The changes in LV mass index (LVMI) were different between the two groups. LV mass index decreased in the exercise group (LVMI -14.3 ± 3.3 g) but not in the controls (LVMI 1.4 ± 4.1 g; p = .009). A multiple stepwise regression analysis showed that among clinical and physiological variables including changes in resting systolic BP, aerobic power, body mass index, and systolic BP during submaximal and maximal exercise, only the reduction in resting systolic BP correlated significantly with a regression of concentric remodeling ( h/r ratio ). The other variables did not add to the ability of the model to predict changes in the h/r ratio.

Conclusions. The data suggest that exercise training can reduce BP and induce partial regression of LVH and LV concentric remodeling in older adults with mild or moderate hypertension.

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