A beneficial effect of physical activity on left ventricular mass( LVM) in the short term has been described in hypertension. Aim of this study was to investigate the long-term effect of regular physical activity on development of left ventricular hypertrophy (LVH) in a cohort of young hypertensive subjects. We studied 454 participants (317 men, mean age 33±8 years) without LVH at baseline whose physical activity status was consistent throughout the follow-up. BP was 146±11/94±5 mm Hg at baseline and 141±/90±8 mmHg after 3 months of non-pharmacological measures. Subjects were divided into 3 categories of physical activity (sedentary, n=281;leisure-time activities, n=140; competitive sports, n=33). Patients were seen every six months until they developed hypertension. Echocardiographic LVM was measured at entry, every 5 years, and/or at the time of hypertension development. Active subjects were younger (31±8 versus 34±8 years, p=.000) and leaner (24.4±3.0 vs 25.2±3.7 Kg/m2, p=.006) than sedentary ones, and were more frequently male (45% versus 22%, p=.000). During a median follow-up of 8.2 years, 32 subjects(7.3%) developed LVH (sedentary=10.3%, leisure-time activities=2.1%, competitive sports= 0%, p=.002). In a logistic regression, physically active groups combined (n=173) were less likely to develop LVH than the sedentary group with a crude OR=0.16 (CI, 0.05– 0.55). After controlling for sex, age, family history for hypertension, body weight, smoking, alcohol and coffee use, blood pressure, LVM, and follow-up time, the OR was 0.22 (CI, 0.06 – 0.77). BP declined over time in physically active subjects (−5.1±17.0/−0.5±10.2 mmHg) and slightly increased in sedentary ones (0.0±15.3/0.9±9.7 mmHg, adjusted p versus active=0.04/0.06). Inclusion of changes in BP over time into the logistic model slightly decreased the strength of the association between physical activity status and LVH development (OR=0.24,CI, 0.07– 0.85). Regular physical activity prevents the development of LVH in young stage 1 hypertensive subjects. Leisure-time and competitive sports activities seem to have both a beneficial effect on LVM. This effect is only partially dependent on the reduction in BP caused by exercise.
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