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Muscle Weakness Is Associated With an Increase of Left Ventricular Mass Through Excessive Blood Pressure Elevation During Exercise in Patients With Hypertension.

Abstract Autonomic imbalance in hypertension induces excessive blood pressure (BP) elevation during exercise, thereby increasing left ventricular mass (LVM). Although muscle weakness enhances autonomic imbalance by stimulating muscle sympathetic activity during exercise, it is unclear whether muscle weakness is associated with an increase of LVM in patients with hypertension. This study aimed to investigate the relationships between muscle weakness, BP elevation during exercise, and LVM in these patients. Eighty-six hypertensive patients aged 69 ± 8 years with controlled resting BP (ie, < 140/90 mmHg) were recruited. Plasma brain natriuretic peptide (BNP), left ventricular mass index (LVMI), and knee extension muscle strength were measured. Changes in plasma noradrenaline (NORA) and brachial-ankle pulse wave velocity (ba-PWV) were assessed before and after an ergometer exercise test performed at moderate intensity (ΔNORA and ΔPWV, respectively). A difference between baseline and peak systolic BP during the exercise test was defined as BP elevation during exercise (ΔSBP). Relationships between muscle strength, ΔNORA, ΔPWV, ΔSBP, BNP, and LVMI were analyzed, and significant factors increasing LVM were identified using univariate and multivariate regression analyses. Muscle strength was negatively correlated with ΔNORA (r = -0.202, P = 0.048), ΔPWV (r = -0.328, P = 0.002), ΔSBP (r = -0.230, P = 0.033), BNP (r = -0.265, P = 0.014), and LVMI (r = -0.233, P = 0.031). LVMI was positively correlated with ΔPWV (r = 0.246, P = 0.023) and ΔSBP (r = 0.307, P = 0.004). Muscle strength was a significant independent factor associated with LVMI (β = -0.331, P = 0.010). Our findings suggest that muscle weakness is associated with an increase of LVM through excessive BP elevation during exercise in patients with hypertension.
PMID
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Authors

Mayor MeshTerms
Keywords

Arterial stiffness

Autonomic activity

Cardiac overload

Muscle strength

Journal Title international heart journal
Publication Year Start




PMID- 28701669
OWN - NLM
STAT- MEDLINE
DA  - 20170713
DCOM- 20170810
LR  - 20170810
IS  - 1349-3299 (Electronic)
IS  - 1349-2365 (Linking)
VI  - 58
IP  - 4
DP  - 2017 Aug 03
TI  - Muscle Weakness Is Associated With an Increase of Left Ventricular Mass Through
      Excessive Blood Pressure Elevation During Exercise in Patients With Hypertension.
PG  - 551-556
LID - 10.1536/ihj.16-293 [doi]
AB  - Autonomic imbalance in hypertension induces excessive blood pressure (BP)
      elevation during exercise, thereby increasing left ventricular mass (LVM).
      Although muscle weakness enhances autonomic imbalance by stimulating muscle
      sympathetic activity during exercise, it is unclear whether muscle weakness is
      associated with an increase of LVM in patients with hypertension. This study
      aimed to investigate the relationships between muscle weakness, BP elevation
      during exercise, and LVM in these patients. Eighty-six hypertensive patients aged
      69 +/- 8 years with controlled resting BP (ie, &lt; 140/90 mmHg) were recruited.
      Plasma brain natriuretic peptide (BNP), left ventricular mass index (LVMI), and
      knee extension muscle strength were measured. Changes in plasma noradrenaline
      (NORA) and brachial-ankle pulse wave velocity (ba-PWV) were assessed before and
      after an ergometer exercise test performed at moderate intensity (DeltaNORA and
      DeltaPWV, respectively). A difference between baseline and peak systolic BP
      during the exercise test was defined as BP elevation during exercise (DeltaSBP). 
      Relationships between muscle strength, DeltaNORA, DeltaPWV, DeltaSBP, BNP, and
      LVMI were analyzed, and significant factors increasing LVM were identified using 
      univariate and multivariate regression analyses. Muscle strength was negatively
      correlated with DeltaNORA (r = -0.202, P = 0.048), DeltaPWV (r = -0.328, P =
      0.002), DeltaSBP (r = -0.230, P = 0.033), BNP (r = -0.265, P = 0.014), and LVMI
      (r = -0.233, P = 0.031). LVMI was positively correlated with DeltaPWV (r = 0.246,
      P = 0.023) and DeltaSBP (r = 0.307, P = 0.004). Muscle strength was a significant
      independent factor associated with LVMI (beta = -0.331, P = 0.010). Our findings 
      suggest that muscle weakness is associated with an increase of LVM through
      excessive BP elevation during exercise in patients with hypertension.
FAU - Kamada, Yumi
AU  - Kamada Y
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
AD  - Sohbudai Nieren Clinic.
FAU - Masuda, Takashi
AU  - Masuda T
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
AD  - Department of Rehabilitation Sciences, Kitasato University Graduate School of
      Medical Sciences.
FAU - Tanaka, Shinya
AU  - Tanaka S
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
FAU - Akiyama, Ayako
AU  - Akiyama A
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
FAU - Nakamura, Takeshi
AU  - Nakamura T
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
FAU - Hamazaki, Nobuaki
AU  - Hamazaki N
AD  - Department of Cardiovascular Medicine, Kitasato University Graduate School of
      Medical Sciences.
FAU - Okubo, Michihito
AU  - Okubo M
AD  - Sohbudai Nieren Clinic.
FAU - Kobayashi, Naoyuki
AU  - Kobayashi N
AD  - Sohbudai Nieren Clinic.
FAU - Ako, Junya
AU  - Ako J
AD  - Department of Cardiovascular Medicine, Kitasato University School of Medicine.
LA  - eng
PT  - Journal Article
DEP - 20170713
PL  - Japan
TA  - Int Heart J
JT  - International heart journal
JID - 101244240
SB  - IM
MH  - Accelerometry
MH  - Aged
MH  - Blood Pressure/*physiology
MH  - Echocardiography
MH  - Exercise/*physiology
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Hypertension/complications/diagnosis/*physiopathology
MH  - Male
MH  - Muscle Strength/physiology
MH  - Muscle Weakness/diagnosis/*etiology/physiopathology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Arterial stiffness
OT  - Autonomic activity
OT  - Cardiac overload
OT  - Muscle strength
EDAT- 2017/07/14 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/07/14 06:00
AID - 10.1536/ihj.16-293 [doi]
PST - ppublish
SO  - Int Heart J. 2017 Aug 3;58(4):551-556. doi: 10.1536/ihj.16-293. Epub 2017 Jul 13.