Should physical exercise and antihypertensive drug therapy be used for the prevention of treatment of left hear enlargement?

This study was carried out to examine the use of anti-high blood pressure (HBP) drug therapy with physical exercise therapy to prevent and reverse left ventricle hypertrophy (LVH; the thickening of the left side of the heart) in patients with HBP. The authors found that anti-HBP drug therapy and physical exercise should be considered for the prevention and treatment of LVH in patients with HBP.

HBP can cause or is related to a condition within the heart called hypertensive heart disease. This is caused by a large left ventricle (LVH), or poor function of the left side of the heart. This can change the shape of the heart. The change of heart shape often results in a decrease in heart function. These conditions can cause conditions such as heart failure (HF) and ischemic (lack of oxygen) heart disease (IHD). 

HBP combination therapy can often lead to LVH decreasing. This therapy includes HBP drug therapy and physical exercise. However, there have been few studies that have looked at the effects of combined drug and physical exercise therapy can have on improving heart function. 

This study analyzed the results of 5 other studies with a total number of 1738 patients. Studies that were included had a minimum follow-up time-frame of 4 months. The longest follow-up period was 12 years. The patients were divided into a non-trained (received BP drugs only) group and a trained (received both BP drugs and physical exercise therapy) group. 

Combined therapy with anti-HBP drugs and physical activity resulted in a significantly decreased left ventricle (LV) mass. Heart rate was also found to be significantly decreased in the trained group when compared to the control group. There was a trend of increasing ejection-fraction (EF) (how much blood is pumped out of the heart) found in the trained group when compared to the control group. An increased EF means a good heart function. 

In two of the studies examined, BP was found to have decreased in patients in trained groups which was not found in the control group. There was a decreasing trend in blood pressure (BP) of patients, however, this was thought to have come from the drug therapy given previously as the patients were already in a normal BP range before starting physical exercise. 

The authors found that the combination of anti-HBP drug therapy along with physical exercise can reduce LV thickness and heart rate. The authors suggest that combined-therapy should be considered for the prevention and treatment of LVH in patients with HBP.