Link Between Weight Training, Left Ventricular Hypertrophy, and Blood Pressure

The relationship between resistance training, left ventricular hypertrophy, and blood pressure?

Hello Dr.
Lee, I am 37 years old, with a height of 169 cm and a weight of 70 kg, and a body fat percentage of 16.
I do not stay up late and have a long-standing habit of aerobic exercise (mainly jogging for about 20-30 minutes each session).
After three years of engaging in weight training, I discovered during my annual health check in the second year of weight training that I have developed left ventricular hypertrophy (LVH), which I had not experienced before.
Initially, I read other articles suggesting that this might be a sign of a stronger heart due to regular exercise, so I did not think much of it.
However, in the third year of weight training, I noticed that my blood pressure, which used to be within the normal range of 120/80, is now fluctuating between 135/90 and 145/95, which has been discouraging for someone who continues to exercise regularly.
I have several questions I would like to ask you, Dr.
Lee:
1.
Are there clinical studies that indicate that resistance (anaerobic) training can cause left ventricular hypertrophy?
2.
If this is indeed caused by weight training, should I adjust my training regimen? Should I even consider giving up weight training altogether?
3.
Is it possible that the left ventricular hypertrophy is contributing to my hypertension?
4.
I have been consuming unseasoned nuts as breakfast and afternoon snacks for the past year.
Could this be the reason for my elevated cholesterol levels (last year it was in the 170s, and this year it is in the 190s), which may be contributing to my hypertension?
5.
If I manage to lower my cholesterol levels, is there a chance that my blood pressure will also decrease?
6.
Lastly, will my left ventricular hypertrophy affect the intensity of my weight training?
7.
Following up on the previous question, should I treat my left ventricular hypertrophy before returning to my original exercise intensity?
I apologize for asking so many questions at once, and I appreciate your patience in reading and answering them.
Thank you very much! 🙏

Irwin, 30~39 year old female. Ask Date: 2022/02/06

Dr. Li Shengkai reply Cardiology

Based on your description, your body fat percentage is low, and with a high level of physical activity, I suspect that the electrocardiogram shows "left ventricular hypertrophy with strain" (LVH with strain).
(1) Athletes, due to high-intensity training and prolonged stimulation, can experience benign hypertrophy of the heart muscle, leading to athletic heart syndrome.
(2) Athletic heart syndrome is a physiological adaptation to exercise, enhancing the heart's ability to pump blood to support high-intensity activities; if you do not experience any significant discomfort, there is no need to alter your existing exercise habits.
(3) Chronic high blood pressure can lead to hypertrophy of the heart muscle, similar to how the heart undergoes weight training; the hypertrophy occurs as a response to resist high blood pressure and maintain adequate blood flow.
It is theoretically possible that increased contraction strength of the heart muscle could lead to elevated blood pressure, but our bodies automatically regulate this, with blood vessels relaxing in response to increased cardiac output, keeping blood pressure within an appropriate range.
Therefore, if your blood pressure at home exceeds 130 mmHg, it may indicate hypertension.
(4) The standard for total cholesterol is 200; as one ages, metabolism tends to decline, leading to gradual increases, but a level of 190 is still within the normal range.
(5) Both hyperlipidemia and hypertension are risk factors for cardiovascular disease and may influence each other, but they do not have a significant correlation; thus, if either is elevated, both should be managed.
(6) If you do not experience any significant physical discomfort, there is no need to change your exercise habits.
(7) I recommend measuring your blood pressure every morning and evening; if the readings are consistently high, you should seek medical attention.
It is not always necessary to take medication to control blood pressure; you can start with lifestyle modifications using the S-ABCDE approach: S (sodium-restricted diet), A (moderate alcohol consumption), B (weight loss), C (smoking cessation), D (DASH diet), E (regular exercise).

Reply Date: 2022/02/06

More Info

Hello! Thank you for your detailed questions regarding the link between weight training, left ventricular hypertrophy (LVH), and blood pressure. Let's address each of your concerns systematically.

1. Clinical Research on Weight Training and LVH: Yes, there is clinical evidence that resistance training, particularly heavy weight lifting, can lead to left ventricular hypertrophy. This is often seen as a physiological adaptation to increased workload on the heart. The heart muscle thickens to manage the increased demand for blood flow during intense physical activity. While this is a normal response in athletes, it can sometimes lead to pathological changes if the hypertrophy is excessive or if there are underlying cardiovascular issues.

2. Adjusting Training: If your LVH is confirmed and is significant, it may be wise to reassess your weight training regimen. This doesn't necessarily mean you need to abandon weight training altogether, but you might consider modifying your approach. Incorporating lighter weights with higher repetitions, focusing on proper form, and ensuring adequate recovery can help mitigate excessive strain on the heart.

3. Connection Between LVH and Hypertension: LVH can indeed be associated with elevated blood pressure. The thickening of the heart muscle can lead to increased stiffness and reduced compliance, which may contribute to higher systolic and diastolic pressures. However, it’s also important to consider other factors such as genetics, diet, and lifestyle that can influence blood pressure.

4. Diet and Cholesterol Levels: Consuming nuts as a snack can be healthy, but moderation is key. Nuts are high in calories and fats, albeit healthy fats. If your overall caloric intake exceeds your energy expenditure, it could contribute to weight gain and potentially higher cholesterol levels. It's essential to balance your diet with a variety of foods and monitor portion sizes.

5. Impact of Lowering Cholesterol on Blood Pressure: Lowering cholesterol can have a positive effect on cardiovascular health, but it may not directly lower blood pressure. However, improving your overall diet and lifestyle can lead to better heart health, which may help manage blood pressure levels.

6. Impact of LVH on Weight Training Intensity: LVH can affect your ability to perform high-intensity weight training. If your heart is under stress due to hypertrophy, it may not respond well to heavy lifting. Monitoring how your body feels during workouts and adjusting intensity accordingly is crucial.

7. Treatment of LVH Before Resuming Intense Training: If your LVH is significant, it may be advisable to consult with a cardiologist. They can provide guidance on whether treatment is necessary and when it would be safe to return to your previous training intensity. Treatment may involve lifestyle changes, medication, or further evaluation to rule out any underlying conditions.

In summary, while weight training can lead to physiological adaptations like LVH, it’s essential to monitor your heart health closely. Adjusting your training regimen, maintaining a balanced diet, and consulting with healthcare professionals can help you manage your blood pressure and overall cardiovascular health effectively. Always listen to your body and prioritize your health above performance. Thank you for your thoughtful questions, and I hope this information helps you on your fitness journey!

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