[The determinants of exercise tolerance in patients with hypertensive cardiopathy]

A study was made of 45 patients with arterial hypertension, no prior angina or myocardial infarction, mean age 64 +/- 5 years, and ejection fraction > 50%. Twenty (group I) had congestive heart failure while 25 (group II) were asymptomatic. Testing following remission of symptoms revealed impaired exercise tolerance (VO2 max < 20 ml/kg/min) in 22 (subgroup A-80% from group I), and normal tolerance in 23 (subgroup B). Of ventricular function indexes, only peak filling rate correlated significantly with VO2 max (r = 0.65). Of 32 patients with thallium-201 negative in ergometric tests, the 12 in subgroup A had a higher degree of hypertrophy (p > 0.01). Nine thallium-positive patients had lower VO2 max (p > 0.05) than did 17 thallium-negative patients with a similar degree of hypertrophy. Thus, in hypertensive patients, exercise tolerance depends on prior congestive heart failure, diastolic dysfunction, degree of hypertrophy and silent regional ischemia.