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August 22, 1990

Treadmill Testing in Hypertensives-Reply

Author Affiliations

Institute on Aging Baltimore, Md

Institute on Aging Baltimore, Md

JAMA. 1990;264(8):973. doi:10.1001/jama.1990.03450080059026

In Reply.—  Dr Miller raises some interesting issues. In at least two studies, exaggerated blood pressure responses to treadmill exercise testing have correlated with greater left ventricular mass.1,2 Due to the observational design of these studies, however, it is impossible to determine whether exercise habits per se actually caused the increase in left ventricular mass. However, the subjects in both of these studies were not physically trained, making such a cause-and-effect relationship unlikely. A more likely explanation for the relationship between exercise blood pressure and left ventricular mass is that the exaggerated exercise blood pressure response is merely a marker for the presence of left ventricular hypertrophy rather than its cause. No study of which I am aware, including those cited by Dr Miller, demonstrates a longitudinal increase in left ventricular mass by high-repetition/low-resistance training.Although the use of a "screening" treadmill exercise test to assess blood pressure response