Objective To explore the correlation and gender differences between left ventricular (LV) morphology and exercise tolerance in elderly patients with hypertension.

Methods  A total of 835 patients aged≥60 with essential hypertension were included as case groups. According to the Ganau classification, they were divided into four subgroups: normal configuration (NL), concentric remodeling (CR), centrifugal hypertrophy (EH), and concentric hypertrophy (CH). At the same time, 151 non-hypertensive and normal heart configuration people aged ≥ 60 years were collected as a normal control group. The differences were compared in Peak oxygen consumption（Peak VO₂) among the five groups. Multiple linear regression analysis was used to explore the correlation between Peak VO₂ and LV structural parameters, including LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), interventricular septum thickness (IVST), LV posterior wall thickness (PWT), relative ventricular wall thickness (RWT) and LV mass index (LVMI) in total subjects, as well as in men and women.

Results  The Peak VO₂ in the four configuration subgroups of hypertension (NL, CR, EH, CH) was lower than that in the normal control group (16.20 ± 4.93, 15.56 ± 5.18, 13.56 ± 4.92, 13.27 ± 4.40 vs. 18.14 ± 4.76 mL/kg·min, P＜0.001), and the Peak VO₂ of the three abnormal configuration groups was lower than that of the NL group (P＜0.001). The proportions of NL and CR patterns were higher in males than in females, while the proportions of EH and CH patterns were lower in females. Multiple linear regression analysis showed that in the entire elderly hypertensive patients, after adjusting for age, gender, smoking history, alcohol drinking history, systolic blood pressure, diastolic blood pressure, body mass index, duration of hypertension, heart rate, fasting blood glucose, total cholesterol, triglyceride, serum uric acid and antihypertensive medication use, IVST and Peak VO₂ were independently negatively correlated (B = −0.264, P =0.028）. IVST was an independent negative factor correlate to Peak VO₂ in male patients (B = −0.551, P＜0.001), but this correlation was not statistically significant in female patients (B = −0.033, P = 0.323).

Conclusions The exercise tolerance of elderly hypertensive patients is lower than that of non-hypertensive elderly people; and the exercise tolerance of the left ventricular abnormal configuration groups is lower than that of the normal configuration group; IVST is independently negatively correlated with exercise tolerance in elderly male patients.