Reduced ventilatory efficiency encountered in patients with hypertension during exercise

UK: A recent study has found a higher minute ventilation/volume of expired CO2 slope (ventilatory efficiency) in patients with primary hypertension (including patients with treated controlled blood pressure) without a diagnosis of heart failure compared to healthy controls. 

Ventilatory efficiency is evaluated via the relationship between ventilation and carbon dioxide production (minute ventilation/volume of expired CO2 [VE/VCO2]) during incremental exercise. It is a noninvasive measure shown to reflect exercise indexes, such as pulmonary artery wedge pressure and cardiac output, that are normally obtained by invasive means.

The findings, published in the Journal of the American Heart Association could signify early cardiac dysfunction and/or increased cardiac risk.

An elevated ventilatory efficiency slope during exercise is reported to be a strong prognostic indicator in heart failure. It is elevated in patients with heart failure with preserved ejection, majority of them have hypertension. However, it is not known whether r the VE/VCO2 slope is also elevated in people with primary hypertension compared to normotensive individuals. Katrina Hope, University of Bristol, Bristol, United Kingdom, and colleagues hypothesized that there is a spectrum of ventilatory inefficiency in cardiovascular disease, indicating an increasingly abnormal physiological response to exercise. They aimed to evaluate the VE/VCO2 slope in hypertension patients compared with peak oxygen consumption–, age‐, and sex‐matched healthy subjects.