Exercise performance and beta-blockade

Sports Med. 1985 Nov-Dec;2(6):389-412. doi: 10.2165/00007256-198502060-00002.

Abstract

beta-Adrenoceptor blockers (beta-blockers) are common first-choice drugs in the treatment of various cardiovascular disorders. Physical exercise performed during single-dose administration of beta-blockers, however, is associated with an increased rate of perceived exertion; an effect which appears to be partly reduced with long term treatment. Although clinical doses of beta-blockade may reduce heart rate by 30 to 35%, during maximal exercise cardiac output is not equally reduced. Accordingly, most studies have demonstrated increased stroke volume after beta-blockade. This reduction in heart rate is typically accompanied by a decreased VO2max (5 to 15%) in both patients and healthy, trained subjects. This smaller reduction in VO2max, as compared with the decrease in cardiac output, is the result of a partly compensating increased arteriovenous O2 difference. Work capacity as reflected by the ability to perform intense short term or more prolonged steady-state exercise is also impaired following beta-blockade. beta-Adrenoceptors can be subdivided into types beta 1- and beta 2. Blockers which are specific for either beta 1-receptors (beta 1-selective blockers) or both beta 1- and beta 2 receptors (non-selective blockers) differ with regard to their effect on exercise performance. Exercise performance ability, irrespective of exercise intensity and duration, is impaired to a greater extent following non-selective than beta 1-selective blockade at equal reductions in heart rate. This response stems from a decreased energy flux through glycogenolysis during non-selective blockade treatment. Individuals receiving beta-blockade medication therefore show greater adaptive response to physical conditioning during treatment with beta 1-selective than non-selective blockade probably because of greater training intensity with the former therapy. Neither psychomotor performance nor muscular strength and power is negatively affected by beta-blockade. Nevertheless, the ability to perform athletic events requiring high levels of motor control under emotional stress but not high levels of aerobic or anaerobic energy release, is probably increased during beta-blockade.

Publication types

  • Review

MeSH terms

  • Adenine Nucleotides / metabolism
  • Adrenergic beta-Antagonists / pharmacology
  • Adrenergic beta-Antagonists / therapeutic use*
  • Blood Glucose / metabolism
  • Carbohydrate Metabolism
  • Cardiovascular Diseases / physiopathology*
  • Energy Metabolism / drug effects
  • Glycogen / metabolism
  • Hemodynamics / drug effects
  • Humans
  • Lactates / metabolism
  • Lipolysis / drug effects
  • Muscles / metabolism
  • Oxygen Consumption / drug effects
  • Physical Endurance / drug effects
  • Physical Exertion / drug effects*
  • Psychomotor Performance / drug effects
  • Pulmonary Ventilation / drug effects
  • Receptors, Adrenergic, beta / classification
  • Time Factors

Substances

  • Adenine Nucleotides
  • Adrenergic beta-Antagonists
  • Blood Glucose
  • Lactates
  • Receptors, Adrenergic, beta
  • Glycogen