Left Ventricular Hypertrophy in Hypertensive Athletes can be Reduced by Antihypertensive Medication Despite Continuing Intense Aerobic Exercise

Abstract

Introduction: Left ventricular hypertrophy (LVH) can be successfully reduced by antihypertensive medication. Both hypertension and aerobic exercise can cause increases in left ventricular mass (LV-mass).

Aim: Therefore, hypertensive athletes with LVH were studied to investigate the effect of antihypertensive medication on LV-mass reduction despite continuing their regular intensive exercise programs.

Methods: 14 previously untreated hypertensive male athletes (A) with LVH and a prolonged history of endurance training where included in the study. 50 previously untreated inactive comparable hypertensives with LVH served as controls (C). For both groups inclusion criteria were blood pressure (BP) at rest: > 140/90 mmHg, BP during ergometry (at 100 W): > 200/100 mmHg and. LV-mass-index > 125 g/m². Echocardiography was performed to calculate LV-mass and function before and after 3 years of antihypertensive medication.

Results: Despite regularly aerobic training throughout the treatment period, LV mass decreased from 164 ± 19 g/m² before to 97 ± 16 g/m² after 3 years of therapy (p < 0.001). Controls with identical pressures demonstrated a decrease from 149 ± 29 g/m² to 87 ± 15 g m². There were similar decreases in LV wall thicknesses in both groups, whereas diastolic dimensions did not change significantly. Moreover, there was an increase in fractional fiber shortening as a measure of LV pump function in both groups of 15% in A and 11% in C, respectively.

Conclusions: In hypertensive athletes LVH due to hypertension can be reduced and LV-function can be improved by long-term antihypertensive medication despite regular aerobic exercise. Therefore, exercise does not interfere with the regression of LVH on account of antihypertensive therapy in hypertensive subjects.

Keywords: Aerobic exercise; Antihypertensive treatment; Blood pressure; Exercise training; Hypertension; Left ventricular hypertrophy.