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Exercise, Hypertension, and Left Ventricular Mass-Reply

Kerry J. Stewart, EdD; Michael H. Kelemen, MD
JAMA. 1990;264(18):2387. doi:10.1001/jama.1990.03450180043026.
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In Reply.—  As we mentioned in our article, pathological and physiological hypertrophy have been studied primarily in small animal models. A review of these studies1 suggests that despite an increase in left ventricular mass, exercise seems to improve or reverse many of the harmful effects of hypertension-induced pathological hypertrophy. Our study was not designed to evaluate the effects of exercise on the mechanical and/or biochemical properties of the hypertrophied heart. However, our results, during a 10-week period, showed an increase in left ventricular mass without a change in diastolic function, which was consistent with the physiological hypertrophy observed in exercise-trained normotensive persons and athletes. We also asserted, as does Dr Haywood, that there is a need for investigation of the long-term effects of blood pressure reduction by resistive exercise training that may increase left ventricular mass compared with therapies that may reduce left ventricular mass, such as weight


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