Ventilatory Efficiency Impaired in Hypertension


  • Ventilatory efficiency is assessed using the relationship between ventilation and carbon dioxide production (minute ventilation/volume of expired COor VE/VCO2).

  • The VE/VCOslope is elevated in people with heart failure with preserved ejection, but it's unclear whether it's also elevated in people with primary hypertension.

  • The study included 55 patients with primary hypertension without heart failure and 24 participants with normal blood pressure who were matched for age, sex, body mass index, and cardiovascular fitness.

  • Participants completed ramped cardiovascular pulmonary exercise tests to peak oxygen consumption on a bike ergometer. VE/VCOslope was calculated throughout, and blood pressure was measured every 1 to 2 minutes.


    • When grouped by a suggested slope classification, only 27.3% of participants with hypertension had a normal value (VE/VCO2 slope of 20–30), compared with 70.8% of normotensive individuals.

    • The VE/VCOslope was higher in the hypertensive group compared with the control group (31.8 vs 28.4; = .002).

    • Peak breathing frequency was elevated in individuals with hypertension (34 vs 31 breaths/min; = .048), but peak end tidal carbon dioxide was lower in patients with hypertension than in normotensive individuals, with no difference in peak end tidal oxygen.

    • As for subgroups, the VE/VCOslope was higher in untreated and treated-controlled hypertensive individuals than in normotensive individuals; in the treated-uncontrolled group, there was no difference.



    Adding this noninvasive measure might be useful in the future for risk stratification and for making treatment decisions, the authors conclude.