European Heart Journal Advance Access published online on December 11, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn533
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Regular physical activity prevents development of left ventricular hypertrophy in hypertension
1 Clinica Medica 4, University of Padova, via Giustiniani, 2, 35128 Padova, Italy
2 Town Hospital, Vittorio Veneto, Italy
3 Town Hospital, Trento, Italy
4 Town Hospital, Mirano, Italy
5 Town Hospital, Rovigo, Italy
6 Town Hospital, San Daniele del Friuli, Italy
Received 25 March 2008; revised 7 October 2008; accepted 18 November 2008.
* Corresponding author. Tel: +39 049 8212278, Fax: +39 049 8754179, Email: palatini{at}unipd.it
Aims: The longitudinal relationship between aerobic exercise and left ventricular (LV) mass in hypertension is not well known. We did a prospective study to investigate the long-term effect of regular physical activity on development of LV hypertrophy (LVH) in a cohort of young subjects screened for Stage 1 hypertension.
Methods and results: We assessed 454 subjects whose physical activity status was consistent during the follow-up. Echocardiographic LV mass was measured at entry, every 5 years, and/or at the time of hypertension development before starting treatment. LVH was defined as an LV mass 
50 g/m2.7 in men and 47 g/m2.7 in women. During a median follow-up of 8.3 years, 32 subjects developed LVH (sedentary, 10.3%; active, 1.7%, P = 0.000). In a logistic regression, physically active groups combined (n = 173) were less likely to develop LVH than sedentary group with a crude OR = 0.15 (CI, 0.05–0.52). After controlling for sex, age, family history for hypertension, hypertension duration, body mass, blood pressure, baseline LV mass, lifestyle factors, and follow-up length, the OR was 0.24 (CI, 0.07–0.85). Blood pressure declined over time in physically active subjects (–5.1 ± 17.0/–0.5 ± 10.2 mmHg) and slightly increased in their sedentary peers (0.0 ± 15.3/0.9 ± 9.7 mmHg, adjusted P vs. active = 0.04/0.06). Inclusion of changes in blood pressure over time into the logistic model slightly decreased the strength of the association between physical activity status and LVH development (OR = 0.25, CI, 0.07–0.87).
Conclusion: Regular physical activity prevents the development of LVH in young stage 1 hypertensive subjects. This effect is independent from the reduction in blood pressure caused by exercise.
Key Words: Exercise • Hypertension • Left ventricle • Hypertrophy