The effect of cardiac rehabilitation on blood pressure, and on left atrial and ventricular functions in hypertensive patients

Abstract

Purpose Hypertension is associated with left ventricular (LV) hypertrophy, impaired LV relaxation, and left atrial (LA) enlargement. Cardiac rehabilitation (CR) improves clinical outcomes in a broad spectrum of cardiac disease. The aim of our study was to determine the effect of CR on blood pressure (BP), and on LA and LV functions in hypertensive patients. Methods Thirty consecutive hypertensive patients who would undergo CR program, and 38 hypertensive patients who refused to undergo CR program were included. All patients underwent ambulatory BP monitoring and transthoracic echocardiography, which were repeated after completion of the CR program, or 12 weeks later in the control group. LA and LV functions were assessed by both speckle tracking and 3‐dimensional echocardiography. N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels were assessed before and after CR. Results Although initial ambulatory BP values and NT‐proBNP levels were similar between the groups, daily, day‐time, and night‐time BP and NT‐proBNP were significantly lower in the CR group after rehabilitation. LA reservoir strain and LV global longitudinal strain of the CR group significantly increased after CR while no significant increase was observed in controls. Conclusion CR improves LA and LV strain while lowering BP and should be encouraged in routine management of hypertensive patients.

Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

“…In an uncontrolled study performed on post-AMI patients [38], after six weeks of cardiac rehabilitation LA strain improved, but all other parameters, including atrial volume and diastolic function, were unchanged. More recently, a similar result was obtained with hypertensive patients undergoing cardiac rehabilitation [39]. We did not find any previous data on acute changes of LA function occurring after a single session in hypertensive patients with IHD.…”

Cluster Analysis to Distinguish Patients Most Likely to Benefit from Outpatient Cardiac Rehabilitation—A Prospective, Multicenter Study

“…SBP was also reduced following cardiac rehabilitation in a retrospective, single-centre study among patients requiring primary or secondary prevention [ 17 ]. Similarly, Sahn et al reported that blood pressure decreased in hypertensive patients who took part in a cardiac rehabilitation program but not in those who refused to participate [ 18 ]. In a registry-based study from Austria, outpatient cardiac rehabilitation improved exercise capacity, blood pressure, blood lipids, and glucose [ 19 ].…”

Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation

“…GLS allows the detection of subclinical LV dysfunction in the presence of a preserved LV ejection fraction, adding more accurate and valuable information on systolic function [11,12]. Several studies documented the positive effect of exercise training on GLS, specifically in patients with arterial hypertension [13,14], recent myocardial infarction [15], or recent ST-segment elevation myocardial infarction (STEMI) and LV ejection fraction > 45% [16]. However, other studies showed conflicting data on the improvement in GLS due to the training program [17,18], as well as in oncological patients undergoing cardio-oncology rehabilitation, suggesting the need for further investigations [19].…”