Katrina Hope
Ventilatory efficiency is reduced in people with hypertension during exercise
Hope, Katrina; Chant, Ben; Hinton, Thomas; Kendrick, Adrian H.; Nightingale, Angus K.; Paton, Julian F.R.; Hart, Emma C.
Authors
Ben Chant
Thomas Hinton
Dr Adrian Kendrick Adrian.Kendrick@uwe.ac.uk
Senior Lecturer in Physiological Science (Respiratory/Sleep)
Angus K. Nightingale
Julian F.R. Paton
Emma C. Hart
Abstract
BACKGROUND: An elevated ventilatory efficiency slope during exercise (minute ventilation/volume of expired CO2; VE /VCO2 slope) is a strong prognostic indicator in heart failure. It is elevated in people with heart failure with preserved ejection, many of whom have hypertension. However, whether the VE /VCO2 slope is also elevated in people with primary hypertension versus normotensive individuals is unknown. We hypothesize that there is a spectrum of ventilatory inefficiency in cardiovascular disease, reflecting an increasingly abnormal physiological response to exercise. The aim of this study was to evaluate the VE /VCO2 slope in patients with hypertension compared with age-, peak oxygen consumption–, and sex-matched healthy subjects. METHODS AND RESULTS: Ramped cardiovascular pulmonary exercise tests to peak oxygen consumption were completed on a bike ergometer in 55 patients with primary hypertension and 24 normotensive controls. The VE /VCO2 slope was assessed from the onset of exercise to peak oxygen consumption. Data were compared using unpaired Student t test. Age (mean±SD, 66±6 versus 64±6 years; P=0.18), body mass index (25.4±3.5 versus 24±2.4 kg/m2; P=0.13), and peak oxygen consumption (23.2±6.6 versus 24±7.3 mL/min per kg; P=0.64) were similar between groups. The VE /VCO2 slope was elevated in the hypertensive group versus controls (31.8±4.5 versus 28.4±3.4; P=0.002). Only 27% of the hypertensive group were classified as having a normal VE /VCO2 slope (20–30) versus 71% in the control group. CONCLUSIONS: Ventilatory efficiency is impaired people with hypertension without a diagnosis of heart failure versus normotensive individuals. Future research needs to establish whether those patients with hypertension with elevated VE /VCO2 slopes are at risk of developing future heart failure.
Citation
Hope, K., Chant, B., Hinton, T., Kendrick, A. H., Nightingale, A. K., Paton, J. F., & Hart, E. C. (2023). Ventilatory efficiency is reduced in people with hypertension during exercise. Journal of the American Heart Association, 12(13), Article e024335. https://doi.org/10.1161/JAHA.121.024335
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 6, 2023 |
Online Publication Date | Jun 22, 2023 |
Publication Date | Jul 4, 2023 |
Deposit Date | Mar 12, 2024 |
Publicly Available Date | Mar 12, 2024 |
Journal | Journal of the American Heart Association |
Electronic ISSN | 2047-9980 |
Publisher | Wiley Open Access |
Peer Reviewed | Peer Reviewed |
Volume | 12 |
Issue | 13 |
Article Number | e024335 |
DOI | https://doi.org/10.1161/JAHA.121.024335 |
Public URL | https://uwe-repository.worktribe.com/output/11793943 |
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Ventilatory efficiency is reduced in people with hypertension during exercise
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