PURPOSE: Being overweight/obese, having hypertension, and being postmenopausal are risk factors for the development of congestive heart failure (CHF). A characteristic of CHF is an abnormal VE/VCO2 slope, which is predictive of mortality in patients with CHF. Although the VE/VCO2 slope is well established in CHF patients, little is known regarding interventions for "at-risk" populations. METHODS: We examined the VE/VCO2 slope in 401 sedentary, overweight, moderately hypertensive women randomized to 6 m of nonexercise (control) or 4 kcal/kg/wk (KKW), 8 KKW, or 12 KKW of exercise at an intensity corresponding to 50% of baseline VO2max. We examined trends in exercise treatment dose versus change in mean VE/VCO2 slope using a linear regression model (KKW versus VE/VCO2 slope) and a linear mixed model. RESULTS: Regression analysis showed a significant trend for a reduction in the VE/VCO2 slope from baseline (mean +/- SD: 32.6 +/- 6.3; p < 0.004). When expressed as mean change (95% confidence interval (CI)) from baseline, we observed significant reductions in the VE/VCO2 slope for the 8-KKW (-1.14; 95% CI -1.5 to -0.2) and 12-KKW (-1.67; 95% CI -2.3 to -0.3) groups. No significant effect was noted for the 4-KKW (-0.4; 95% CI -1.2 to 0.15) group. CONCLUSION: Moderate-intensity aerobic exercise at doses of 8 KKW or greater seems to present an adequate dose of exercise to promote small but significant reductions in the VE/VCO2 slope in postmenopausal women who exhibit risk factors associated with the development of CHF.

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