Effect of moderate physical training on left ventricular mass in mild hypertensive persons

Exercise might reduce blood pressure in mild essential hypertensive individuals, but it could raise left ventricular mass, counteracting the beneficial effects induced by a decrease in blood pressure. Seventeen (group 1) of 25 mild hypertensive patients, nonresponders to a 3-month low sodium diet (2 g/day), were admitted into a physical training program consisting of three weekly sessions of aerobics (20 minutes), bicycling at prefixed loads (20 minutes), and induced muscular relaxation (10 minutes). They were compared with 15 mild hypertensive patients (group 2), nonresponders to the low sodium diet who remained untrained. The follow-up lasted 15.7 +/- 5.8 months. There were significant blood pressure decreases in group 1 at rest (155 +/- 9.8/101 +/- 3.3 vs. 136 +/- 8.1/86 +/- 6.6 mm Hg, p less than 0.001) and at maximal effort (219 +/- 27.4/119 +/- 14.4 vs. 196 +/- 21.8/101 +/- 10.5 mm Hg, p less than 0.001). Maximal work capacity increased from 758.8 +/- 256.7 to 944.1 +/- 203.8 kpm (p less than 0.001). Echocardiographic left ventricular mass index tended to decrease (137.8 +/- 36.3 vs. 125.4 +/- 29.9 g/m2, p = NS), without any significant modification of either left ventricular volume index or left ventricular shortening fraction. No significant changes occurred in group 2. There was no correlation between blood pressure and left ventricular mass changes and left ventricular shortening fraction and left ventricular mass index changes. According to these results, it seems prudent to prescribe physical training to mild hypertensive patients because it does not induce left ventricular mass increases.(ABSTRACT TRUNCATED AT 250 WORDS)

Noninvasive assessment of left ventricular performance after administration of bisoprolol

The effects of single doses of 10, 20, and 40 mg of bisoprolol on left ventricular performance were assessed by left ventricular systolic time interval measurements, echocardiographic measurements, and exercise stress tests in patients with mild to moderate arterial hypertension. Bisoprolol caused a significant, dose-dependent fall in systolic and diastolic blood pressure and heart rate, at rest and under exercise stress test. Left ventricular systolic time intervals were prolonged at the higher doses, but pre-ejection period/left ventricular ejection time (PEP/LVET) ratio, as an indicator for left ventricular performance, remained unchanged. Left ventricular echocardiographic dimensions increased significantly, but shortening fraction was not altered. We conclude that 10-40 mg bisoprolol, apart from the blockade of beta 1-adrenoceptors, does not affect left ventricular cardiac function.