{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T19:07:23Z","timestamp":1786820843711,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              An elevated ventilatory efficiency slope during exercise (minute ventilation\/volume of expired CO\n              <jats:sub>2<\/jats:sub>\n              ; V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope) is a strong prognostic indicator in heart failure. It is elevated in people with heart failure with preserved ejection, many of whom have hypertension. However, whether the V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope is also elevated in people with primary hypertension versus normotensive individuals is unknown. We hypothesize that there is a spectrum of ventilatory inefficiency in cardiovascular disease, reflecting an increasingly abnormal physiological response to exercise. The aim of this study was to evaluate the V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope in patients with hypertension compared with age\u2010, peak oxygen consumption\u2013, and sex\u2010matched healthy subjects.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Ramped cardiovascular pulmonary exercise tests to peak oxygen consumption were completed on a bike ergometer in 55 patients with primary hypertension and 24 normotensive controls. The V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope was assessed from the onset of exercise to peak oxygen consumption. Data were compared using unpaired Student\n              <jats:italic>t<\/jats:italic>\n              test. Age (mean\u00b1SD, 66\u00b16 versus 64\u00b16\u2009years;\n              <jats:italic>P<\/jats:italic>\n              =0.18), body mass index (25.4\u00b13.5 versus 24\u00b12.4\u2009kg\/m\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.13), and peak oxygen consumption (23.2\u00b16.6 versus 24\u00b17.3\u2009mL\/min per kg;\n              <jats:italic>P<\/jats:italic>\n              =0.64) were similar between groups. The V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope was elevated in the hypertensive group versus controls (31.8\u00b14.5 versus 28.4\u00b13.4;\n              <jats:italic>P<\/jats:italic>\n              =0.002). Only 27% of the hypertensive group were classified as having a normal V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slope (20\u201330) versus 71% in the control group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Ventilatory efficiency is impaired people with hypertension without a diagnosis of heart failure versus normotensive individuals. Future research needs to establish whether those patients with hypertension with elevated V\n              <jats:sub>E<\/jats:sub>\n              \/VCO\n              <jats:sub>2<\/jats:sub>\n              slopes are at risk of developing future heart failure.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024335","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T12:19:11Z","timestamp":1687436351000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Ventilatory Efficiency Is Reduced in People With Hypertension During Exercise"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2960-759X","authenticated-orcid":false,"given":"Katrina","family":"Hope","sequence":"first","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Chant","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hinton","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian H.","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"},{"name":"Department of Respiratory Medicine University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9435-726X","authenticated-orcid":false,"given":"Angus K.","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"},{"name":"Department of Cardiology Bristol Heart Institute, University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian F. R.","family":"Paton","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medical and Health Sciences The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4534-9586","authenticated-orcid":false,"given":"Emma C.","family":"Hart","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute CardioNomics Research Group, School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences University of Bristol Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11911-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006729"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13761"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2202033"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_1_7_2","unstructured":"NICE (National Institute for Health & Care Excellence) . Hypertension in adults: diagnosis and management. NICE (National Institute for Health & Care Excellence). 2019;1\u201351. Accessed March 20 2022. https:\/\/www.nice.org.uk\/guidance\/ng136"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.686576"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313476962"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051530"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.74.1.27"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00523-4"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.940"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.024335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:00:14Z","timestamp":1715598014000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.024335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":12,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2023,7,4]]}},"alternative-id":["10.1161\/JAHA.121.024335"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.024335","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]},"assertion":[{"value":"2022-09-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e024335"}}