Document Detail

Beta-blockers do not impair the cardiovascular benefits of endurance training in hypertensives.
MedLine Citation:
PMID:  17330056     Owner:  NLM     Status:  MEDLINE    
Aerobic physical exercise is broadly recommended as a helpful adjunct to obtain blood pressure control in hypertension. Beta-blockade interacts with heart rate, sympathetic tone, maximal workload and local lactate production. In the present randomized-controlled study, we compared the cardiovascular effects of an endurance training programme in elderly hypertensives with or without beta-blockers and developed a first approach to determine a lactate-based training heart rate in presence of beta-blockade. Fifty-two patients (23 with beta-blocker, 29 without beta-blocker) > or =60 years with systolic 24-h ambulatory blood pressure (ABP) > or =140 mm Hg and/or antihypertensive treatment were randomly assigned to sedentary activity or a heart-rate controlled 12-week treadmill exercise programme (lactate 2.0 mmol/l). In the exercise group, the training significantly decreased systolic and diastolic 24-h ABP, blood pressure on exertion (100 W) and increased endothelium-dependent vasodilation (flow-mediated vasodilation, FMD) and physical performance both in the presence and absence of beta-blockade (P<0.05 each). The extent of ABP reduction did not significantly differ in the presence or absence of beta-blockade (Delta systolic ABP 10.6+/-10.5 vs 10.6+/-8.8 mm Hg, Delta diastolic ABP 5.7+/-8.6 vs 5.8+/-4.0 mm Hg). Mean training heart rate was significantly lower in the patients on beta-blockers (97.2+/-7.7 vs 118.3+/-7.5/min, P<0.001). Lactate-based aerobic endurance training evokes comparable cardiovascular benefits in the presence and absence of beta-blockade including a marked improvement of endothelial function. In the present study, target training heart rate with beta-blockers is about 18% lower than without.
T H Westhoff; N Franke; S Schmidt; K Vallbracht-Israng; W Zidek; F Dimeo; M van der Giet
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-03-01
Journal Detail:
Title:  Journal of human hypertension     Volume:  21     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-17     Completed Date:  2007-10-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  486-93     Citation Subset:  IM    
Medizinische Klinik IV - Nephrology, Charité - Campus Benjamin Franklin, Berlin, Germany.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Endothelial Cells / physiology
Heart / physiology
Heart Rate / drug effects
Hypertension / drug therapy*
Physical Endurance / drug effects*,  physiology
Physical Exertion / drug effects*,  physiology
Vasodilation / drug effects
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents

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