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Beta-blockers with the smallest negative impact on cardiorespiratory fitness in healthy people


Authors: E. Sovová;  L. Štégnerová;  M. Sovová;  M. Koudelka;  D. Tučková;  R. Jochcová;  M. Klugar
Authors‘ workplace: Klinika tělovýchovného lékařství a kardiovaskulární rehabilitace LF UP a FN Olomouc I. interní klinika – kardiologická LF UP a FN Olomouc
Published in: Kardiol Rev Int Med 2016, 18(3): 199-202

Overview

Physical activity belongs to the basic preventive and therapeutic methods in cardiology. A correct setup of physical activity is the base for better patient compliance and a better therapeutic effect. However, certain drugs can affect patients’ physical ability and performance. This applies especially to beta-blockers, which are used in patients with ischaemic heart disease, hypertension, heart failure and other diseases. The aim of this literary review was to find which beta-blockers (or their forms) have the smallest negative effect on cardiorespiratory fitness in healthy patients.

Methods:
The review question “Which beta-blockers have the smallest negative effect on cardiorespiratory ability in healthy patients?” was created using the PICO instrument and the keywords in PICO were used for the search strategy, corrected according to medical terms and thesaurus used in the databases. The search was done in May 2015 in databases Ovid Medline, Embase and Cinahl. The relevance of the studies was assessed by two independent reviewers.

Results:
842 studies were found in Ovid MedLine, 1174 in Embase and 5 in Cinahl (a total of 2021). A total of 417 duplicated studies were excluded. We found 5 relevant studies comparing the effect of administration of at least 2 different beta-blockers on the respiratory stress test in 64 healthy persons. Only 1 of these studies assessed the influence of beta-blockers on the maximum (peak) oxygen consumption.

Conclusion:
According to the reviewed studies, carvedilol and nebivolol were showed to have the best combination of properties with the lowest influence on the cardiorespiratory ability in healthy patients.

Keywords:
beta-blockers – physical activity – affecting of cardiorespiratory fitness


Sources

1. Widimský J Sr. Postavení betablokátorů v léčbě hypertenze, ICHS a srdečního selhání. Hypertenze a kardiovaskulární prevence 2015; 2: 4–7.

2. Larochelle P, Tobe SW, Lacourciere Y. Beta blockers in hypertension: studies and meta-analyses over the years. Can J Cardiol 2014; 30 (5 Suppl): S16–S22. doi: 10.1016/j.cjca.2014.02.012.

3. Mancia G, Fagard R, Narkiewicz K et al. Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281–1357. doi: 10.1097/01.hjh.0000431740.32696.cc.

4. Piepoli MF, Hoes AW, Agewall SA at al. 2016 European Gudelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37 (29): 2315–2381. doi: 10.1093/eurheart/ehw106.

5. Chaloupka V. Aerobní kapacita u nemocných s ischemickou chorobou srdeční. Kardiol Rev 2008; 10: 92–95.

6. Van Baak MA. Beta-adrenoceptor blockade and exercise. An update. Sports Med 1988; 5: 209–225.

7. Anderson RL, Wilmore JH, Joyner MJ et al. Effects of cardioselective and nonselective beta- adrenergic blocade on the performance of highly trained runners. Am J Cardiol 1985; 55: 149–154.

8. Wolfel EE, Hiatt WR, Brammell HL et al. Effects of selective and nonselective beta adrenergic blocade on mechanisms of exercise conditioning. Circulation 1986; 74: 664–674.

9. Marečková J, Klugarová J, Klugar M et al. Evidence-Based Healthcare: Zdravotnictví založené na vědeckých důkazech. 1. vyd. Olomouc: Univerzita Palackého 2015.

10. Glasziou P, Del Mar C, Salisbury J. Evidence-based practice workbook. John Wiley & Sons 2009.

11. Campbell JM, Klugar M, Ding S et al. Diagnostic test accuracy: methods for systematic review and meta-analysis. Int J Evid Based Healthc 2015; 13: 154–162. doi: 10.1097/xeb.0000000000000061.

12. Billeh R, Hirsh D, Barker C et al. Randomized, double blind comparison of acute beta-blockade with 50 mg metoprolol tartate vs 25 mg carvediol in normal subjects. Conquest Heart Fail 2006; 12: 254–257.

13. Stoschitzky K, Koshucharova G, Zweiker R et al. Differing beta-blocking effects of carvediol and metoprolol. Eur J Heart Fail 2001; 3: 343–349.

14. Koshucharova G, Klein W, Lercher P et al. Different beta blocking effects of carvediol and bisoprolol in humans. J Clin Basic Cardiol 2001; 4: 53–56.

15. Stoshitzky K, Stoschitzky G, Brussee H et al. Comparing beta-blocking effects of bisoprolol, carvediol and nebivolol. Cardiology 2006; 106: 199–206.

16. Herman RB, Jesudason PJ, Mustafa AM et al. Differential effects of carvediol and atenolol on plasma nodadrenaline during exercise in humans. Br J Clin Pharmacol 2003; 55: 134–138.

17. Laukkanen JA, Zaccardi F, Khan H et al. Long-term change in cardiorespiratory fitness and all cause mortality: a population based follow up study. Mayo Clin Proc 2016; 91 (9): 1183–8. doi: 10.1016/j.mayocp.2016.05.014.

18. Chomsky DB, Lang CC, Rayos GH et al. Hemodynamic exercise testing. A valuable tool in the selection of cardiac transplantation candidates. Circulation1996; 94: 3176–3183.

19. Kannel WB, Kannel C, Paffenbarger RS Jr et al. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J 1987; 113: 1489–1494.

20. Bangalore S, Sawhney S, Messerli FH. Relation of beta-blocker induced heart rate lowering and cardioprotection in hypertension. J Am Coll Cardiol 2008; 52: 1482–1489. doi: 10.1016/j.jacc.2008.06.048.

21. Lang CC, Chomsky DN, Rayos G et al. Effects od sympathoinhibition on exercise performance in heart failure. Circulation 1997; 96: 238–245.

22. Stoschitzky K, Stoschitzky G, Klein W et al. Different effects of exercise on plasma concentrations of nebivolol, bisoprolol and carvediol. Cardiovasc Drug Ther 2004; 18: 135–138.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology

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