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Beta-adrenoceptor blockade and exercise. An update.

M A Van Baak1

  • 1Department of Pharmacology, University of Limburg.

Sports Medicine (Auckland, N.Z.)
|April 1, 1988
PubMed
Summary
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Beta-blockers impair exercise capacity by affecting heart rate, blood flow, and energy metabolism. These effects reduce both maximal and submaximal endurance performance, particularly in hypertensive individuals.

Area of Science:

  • Exercise Physiology
  • Cardiovascular Pharmacology
  • Metabolic Adaptations

Background:

  • Beta-adrenoceptor blockade significantly impacts physiological responses during exercise.
  • Understanding these effects is crucial for managing physically active individuals on beta-blocker medication.

Purpose of the Study:

  • To comprehensively review the effects of beta-blockers on haemodynamic, metabolic, and performance adaptations during dynamic exercise.
  • To evaluate the influence of beta-blockers on exercise capacity and trainability in both healthy individuals and patients with cardiovascular disease.

Main Methods:

  • Review of existing literature on beta-blocker administration and exercise physiology.
  • Analysis of haemodynamic, metabolic, and performance data from studies involving beta-blocker users during exercise.

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Main Results:

  • Reduced exercise heart rate, cardiac output, and blood pressure, with diminished skeletal muscle blood flow.
  • Decreased availability of fatty acids for energy and potential reduction in maximal glycogenolytic rate.
  • Impaired maximal aerobic capacity and significantly reduced submaximal endurance performance, though symptom-limited capacity may improve in coronary artery disease patients.
  • Variable effects on thermoregulation and plasma ion concentrations (e.g., increased potassium).

Conclusions:

  • Beta-blockers negatively affect exercise capacity, especially submaximal performance, necessitating careful consideration in active hypertensive patients.
  • Non-selective beta-blockers show a more pronounced impairment of submaximal exercise capacity compared to beta 1-selective agents.
  • Training adaptations appear largely preserved in both healthy individuals and coronary artery disease patients during beta-blocker treatment.