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Exercise performance during losartan- or atenolol-based treatment in hypertensive patients with electrocardiographic

Eva Gerdts1, Hans Björnstad, Richard B Devereux

  • 1Institute of Medicine, University of Bergen, Bergen, Norway. gerdtsev@online.no

Blood Pressure
|October 25, 2006
PubMed

Insights

Antihypertensive treatments effectively reduced blood pressure and left ventricular (LV) mass but did not improve exercise capacity in patients with LV hypertrophy. Persistent myocardial relaxation impairment may explain the lack of enhanced exercise performance.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Exercise Physiology

Background:

  • Hypertension frequently leads to left ventricular (LV) hypertrophy, a condition associated with impaired cardiac function and reduced exercise capacity.
  • Regression of LV hypertrophy is a therapeutic goal, but its impact on functional outcomes like exercise capacity remains incompletely understood.

Purpose of the Study:

  • To evaluate whether regression of left ventricular (LV) hypertrophy, achieved through antihypertensive treatment, improves exercise capacity in hypertensive patients.
  • To compare the effects of losartan- versus atenolol-based antihypertensive regimens on LV mass and exercise performance.

Main Methods:

  • A randomized, blinded study involving 51 hypertensive patients with electrocardiographic LV hypertrophy.
  • Doppler echocardiography at rest and during exercise was performed before and after 1 year of treatment with either losartan or atenolol.
  • Exercise capacity was assessed by peak oxygen uptake during cardiopulmonary exercise testing.

Main Results:

  • Both treatment groups achieved comparable blood pressure reduction.
  • The atenolol group showed less regression of LV mass and had poorer LV ejection fraction and midwall shortening compared to the losartan group.
  • Peak oxygen uptake remained unchanged in both groups, with no significant difference despite lower peak exercise heart rate in the atenolol group.
  • Multivariate analysis indicated that peak oxygen uptake was associated with body mass index, systolic blood pressure, and isovolumic relaxation time, but not with LV mass reduction or treatment type.

Conclusions:

  • Antihypertensive treatment with losartan or atenolol effectively reduces blood pressure and LV mass but does not significantly improve exercise capacity after one year.
  • Persistent impairment in myocardial relaxation, despite LV hypertrophy regression, may be a limiting factor for exercise capacity in these patients.

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