EXERCISE PERFORMANCE IN PATIENTS WITH HYPERTENSION - RELATION TO ELECTROCARDIOGRAPHIC CRITERIA FOR LEFT-VENTRICULAR HYPERTROPHY

The influence of the electrocardiographic diagnosis of left ventricular hypertrophy on exercise performance was assessed in 101 hypertensive patients and 37 control subjects referred to an exercise testing laboratory. Maximal exercise capacity was measured by the duration of a symptom-limited, treadmill test using the modified Bruce protocol. The Romhilt-Estes point score system, as modified by Murphy, was used to define left ventricular hypertrophy by electrocardiographic criteria. After adjusting for age differences between hypertensive and control subjects, the hypertensive group without left ventricular hypertrophy had a shorter exercise duration than the control group (13.0 ± 3.0 vs. 15.3 ± 2.5 min, respectively; p < 0.01). The 16 hypertensive patients with electrocardiographic evidence of hypertrophy had a shorter exercise duration than those without (10.9 ± 2.0 vs. 13.0 ± 3.0 min, respectively; p < 0.01). Multivariate regression analysis indicated that age, gender, systolic blood pressure, and electrocardiographic point score were all significant independent variables in predicting exercise duration (R2 = 0.48, p < 0.0001). Exercise duration was unrelated to QRS amplitude. The authors conclude that electrocardiographic evidence of left ventricular hypertrophy, as manifested by P wave and T wave abnormalities, is associated with an impaired exercise capacity in a hypertensive population without prior myocardial infarction. © 1990.