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Abstract
Neurohormonal factors may account for the fact that patients with similar severity and duration of hypertension develop different degrees of left ventricular hypertrophy (LVH). The purpose of this work was to compare the pressor hormone profiles of hypertensive sub] ects off medic:ation during exercise testing. Nineteen patients, stratified according to echocardiographically diagnosed absence (Group I n = 6) or presence (Group I1 n = 13) of LVH, underwent testing on the treadmill according to the Bruce protocol. Both groups were comparab'le in age, severity and duration of hypertension and reached similar double product at peak exercise. Measurements of plasma renin activity (PRA), plasma catecholamines and vasopressin (AVP) at haseline, peak exercise and post exercise revealed significant differences between groups: Group I had suppressed PRA levels tlnroughout and had significantly higher baseline AVP levels, which increased further at peak effort. Group I1 had significantly higher baseline PRA levels, which tended to increase further at peak. effort, and had suppressed AVP levels throughout. There was a significant negative correlation between percent increments in AVP and increments in double product. Norepinephrine increased significantly with effort in both groups, but the levels attained were higher in Group I. In view of the known negative inotropic action of AVP and the trophic effect of angiotensin, we speculate that lower baseline AVP and higher PRA, together with inability of AVP to increase with effort, may be causally related to development of LVH.