[Importance of detection of hypertensive reaction to physical loading in patients with or without left ventricular hypertrophy and arterial hypertension].

Clinical implications of elevated arterial pressure (AP) in exercise tests were considered in 129 patients with arterial hypertension (AH) and "physiological" left ventricular hypertrophy (LVH). AP changes during veloergometry were compared with results of echocardiography. A rise in systolic AP was identical in "physiological" and pathological LVH while changes of diastolic pressure were greater in the absence of AH. Moreover, AH patients more frequently experienced reduced diastolic AP at a maximum load. These variations positively correlated with thickening of left ventricular (LV) wall and interventricular septum and with enlargement of left atrium, hence with increased myocardial size and greater LVH in patients with AH. All examined cases, with and without AH, suffered diastolic LV dysfunction of myocardial relaxation type associated with a significant 1.2-1.3-fold rise in wave A speed and a 1.3-fold decrease of the E/A ratio. It is concluded that exercise induces hypertensive response even in patients with "physiological" LVH.