Efficacy of exercise training in patients with coronary artery disease who are taking propranolol

The effects of beta-adrenergic blockade on the efficacy of exercise training in patients with coronary artery disease were assessed in a community-based cardiac rehabilitation program. Twenty-five patients took no beta-adrenergic-blocking agent and 17 patients took a constant dose of propranolol during the 3 month study period. Individual exercise prescriptions consisted of an intensity of 70% of maximal workload monitored by heart rate, performed 20 min each session, three sessions per week. Both groups improved in maximal exercise capacity: from 8.7 +/- 1.9 (mean +/- SD) to 9.7 +/- 2.1 mets (p less than .01) in those not taking propranolol and from 6.6 +/- 1.5 to 7.7 +/- 1.8 mets (p less than .01) in those taking the drug. At a workload of 70% of maximal achieved at pretraining testing, heart rate decreased with training from 123 +/- 19 to 113 +/- 17 beats/min (p less than .01) in those not taking propranolol and from 97 +/- 14 to 92 +/- 12 beats/min (p less than .05) in those taking the drug. At a workload of 85% of pretraining maximum, heart rate similarly was lowered with training from 138 +/- 17 to 126 +/- 17 beats/min (p less than .01) in those not taking a beta-blocker and from 107 +/- 13 to 102 +/- 13 beats/min (p less than .02) in those taking propranolol. Thus patients with coronary disease who take propranolol have the same potential to benefit from physical training as patients who do not take beta-blockers, and exercise does not need to be modified because of the drug.