Comparison of beta-adrenoceptor blockers under maximal exercise (pindolol v metoprolol v atenolol)

1 The time-related, comparative beta-adrenoceptor blocking effect of metoprolol 150 mg twice daily, atenolol 100 mg once daily and pindolol 7.5 mg twice daily on heart rate, blood pressure, work performance, blood lactate, free fatty acids and plasma catecholamines was studied in ten males aged 19--25 years by means of repeated maximal bicycle exercise tests. 2 At steady state several differences in effects were noted among the drugs. These could be explained by differences in beta 1-selectivity, potency of the chosen drug-doses and intrinsic sympathomimetic activity (ISA). 3 This study emphasizes the importance of including strong sympathetic stimuli in any model used for comparing beta-adrenoceptor blockers with and without ISA in order not to underrate the effects of beta-adrenoceptor blockers with ISA. 4 In the chosen doses pindolol was more effective, and atenolol less effective than metoprolol in suppressing heart rate and blood pressure responses to maximal exercise.