Background. Moderate intensity exercise blood pressure (BP) is associated with adverse cardiovascular outcomes. The mechanisms of this association are unknown but may be due to central haemodynamic factors. This study sought to determine the relation between moderate-exercise central haemodynamics (including aortic reservoir characteristics) and end organ disease assessed by left ventricular mass index (LVMI).

Methods. Resting and moderate cycle exercise (60–70% heart rate maximum) haemodynamics were recorded in 119 participants with treated hypertension (mean age 65+7 years, 47% male) at baseline and one-year. Brachial BP was recorded by auscultation and central haemodynamics (aortic reservoir pressure, augmentation index, systolic BP, pulse pressure) via radial tonometry. LVMI mass was recorded using real-time 3-dimensional echocardiography.

Results. Baseline to one-year change in LVMI was not related to change in any resting brachial or central haemodynamic variable, or exercise brachial BP (P>0.05 all). However, change in exercise aortic reservoir pressure (integral) was significantly associated with change in LVMI (r=0.244, p=0.006). This relationship was maintained on multiple regression analysis adjusting for age, sex, body-mass index, aortic stiffness and 24-hour ambulatory systolic BP (β=0.001, 95% CI=0.000–0.001, p=0.035).

Conclusions. Moderate exercise aortic reservoir pressure independently predicts changes in LV mass over time. Technology to measure 24-hour ambulatory central haemodynamics (including aortic reservoir characteristics) is now available and should provide additional prognostic information beyond peripheral BP measures.