Cardiac Effects of Exercise Training in Hypertension

Figure 1

Compensatory pathologic hypertrophy induces cardiac remodeling. Concentric cardiomyocyte hypertrophy via increased calcineurin signaling, increased cell death per cardiomyocyte proliferation, increased fibrosis, impaired cardiac function, and decreased 𝛽 adrenergic signaling are all hallmarks of compensatory pathologic hypertrophy. Exercise training decreases blood pressure and rate pressure product in hypertension. However, its effects on overall heart remodeling are unclear. Data in humans show an equivocal response with the heart either getting smaller or showing no change. In animal studies, whole heart enlargement with cardiomyocyte hypertrophy occurs, despite a reduction of calcineurin protein expression. Training decreases the cell death/proliferation ratio, decreases fibrosis, and improves the overall phenotype of the hypertensive heart.