Factors and Prognostic Significance of Impaired Exercise Tolerance in Women over 40 with Arterial Hypertension

Agata Bielecka-Dabrowa, Katarzyna Gryglewska, Agata Sakowicz, Stephan von Haehling, Kamil Janikowski, Marek Maciejewski, Maciej Banach, Agata Bielecka-Dabrowa, Katarzyna Gryglewska, Agata Sakowicz, Stephan von Haehling, Kamil Janikowski, Marek Maciejewski, Maciej Banach

Abstract

The aim of this study was to identify factors influencing maximal oxygen uptake (VO2max) and early identification of the profile of hypertensive women in the perimenopausal period at risk of heart failure. This study included 185 female patients. Regression analyses determined predictors of the lowest VO2max (quartile 1: VO2max < 17 mL/kg/min). Females with the lowest oxygen consumption had a significantly higher level of high sensitive cardiac Troponin T (hs-cTnT) (p = 0.001), higher values of the left atrial (LA) volume, late diastolic mitral annulus velocity (A'), E/E' (p = 0.0003, p = 0.02, p = 0.04; respectively), higher BMI and fat content (kg and %) (p < 0.0001), higher fat free mass (FFM) (kg) (p < 0.0001), total body water content (TBW) (p = 0.0002) as well as extracellular body water content (ECW) (p < 0.0001) and intracellular body water content (ICW) (p = 0.005), ECW/TBW × 100% (p < 0.0001) and metabolic age (p < 0.0001) and lower E' (p = 0.001) compared to controls. In a multiple logistic regression model independently associated with VO2max were: ECW/TBW × 100% (OR 4.45, 95% CI: 1.77-11.21; p = 0.002), BMI (OR 7.11, 95% CI: 2.01-25.11; p = 0.002) and hs-cTnT level (OR 2.69, 95% CI: 1.23-5.91; p = 0.013). High-sensitivity cardiac troponin may serve as an early biomarker of heart failure in hypertensive women. Hydration status should be considered in overall hypertensive women care. There is an importance of body mass compartments analysis in the early identification of hypertensive females at risk of heart failure. Optimization and personalization of body structure may be a preventive method for this disease. ClinicalTrials.gov Identifier: NCT04802369.

Keywords: body mass compartments; exercise intolerance; hypertension; personalization of body structure; troponin.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver-operating characteristic curve (ROC) for the ECW/TBW × 100% variable revealing its diagnostic potential. AUC -area under the ROC curve.
Figure 2
Figure 2
Receiver-operating characteristic curve (ROC) for the BMI variable revealing its diagnostic potential. AUC -area under the ROC curve.

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