Significant left ventricular hypertrophy in subjects with normal resting pressures but exaggerated pressure response...

Concentric left ventricular hypertrophy (LVH) frequently occurs in subjects with normal resting systolic and diastolic pressures (SP and DP, respectively). LVH in this normotensive-hypertrophic group (NH) may be due to an abnormally exaggerated pressure response to exercise. The SP and DP responses to exercise were studied in 130 subjects free from coronary artery disease or cardiomyopathy. The NH subjects (n = 35) had normal resting pressure (SP < or = 140 and DP < or = 85 mmHg) and increased LV wall thickness (T) by echocardiography (T > 1.1 cm). A normal control group (NN) (n = 57) and a hypertensive control group (HH) (n = 23) were simultaneously evaluated. The original groups, subgroups censored for age and weight, and matched-pair subgroups demonstrated greater exercise SP for NH than for NN (p < 0.005). Moreover, the rate of SP increase with exercise was greater for NH than for NN or HH (p < 0.05). Hence, an exaggerated exercise SP response may have been the stimulus for LVH in these NH subjects.