title: Effects of 4 month exercise on left ventricular remodeling and autonomic nervous system in hypertensive patients.
abstract: BACKGROUND
  We sought to investigate effects of supervised exercise training on left ventricular remodeling, left ventricular function and autonomic nervous system of hypertensive patients without medication.
  
  
  METHODS
  Fifty borderline and mildly hypertensive patients were enrolled and randomly divided into 2 groups (25 in each). Exercise group received a 4 months' exercise program, prescribed according to their first cardiopulmonary exercise tests, while the control group received routine dietary recommendation. All patients underwent noradrenalin assay, cardiopulmonary exercise tests and echocardiographic studies at enrollment and 4 month follow-up.
  
  
  RESULTS
  At baseline no statistically difference between the two groups were observed in clinical characteristics, echographic variants or cardiopulmonary test index. Four months later, exercise group showed higher values of VO2peak, Powermax (max workload), AT (anaerobic threshold), VO2AT (VO2 at anaerobic threshold), tAT (time from beginning to anaerobic threshold) and heart rate recovery compared to the control group (P<0.05). Additionally, systolic/diastolic blood pressure decreased significantly in the exercise group compared to the control group (P<0.05). Moreover, there was significant reduction in left ventricular mass index in the exercise group (P<0.01), and there was also an inverse correlation between changes in left ventricular mass index and heart rate recovery (r=-0.52, P<0.01).
  
  
  CONCLUSIONS
  Four-month exercise training in borderline and mildly hypertensive patients not only decreased their blood pressure levels, but also induced an improvement of exercise capability, left ventricular remodeling and heart rate recovery. Heart rate recovery improvement was significantly associated with decrease of left ventricular mass index, which indicated that favorable adjustment in autonomic nervous system of exercise training might be an important pathway to reverse left ventricular remodeling.
authors.affiliation: Geriatrics Department, Tongji Hospital Affiliated to Tongji University, Shanghai, P.R. China - lmfc2013@163.com.
authors.forename: Huan
authors.initials: H
authors.lastname: Zheng
authors.forename: Nanzi
authors.initials: N
authors.lastname: Xie
authors.forename: Huifeng
authors.initials: H
authors.lastname: Xu
authors.forename: Junling
authors.initials: J
authors.lastname: Huang
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Xie
authors.forename: Ming
authors.initials: M
authors.lastname: Luo
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002681:China; D018618:Echocardiography, Doppler, Color; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D006321:Heart / Q000294:innervation*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling