Cardiovascular, Respiratory and Metabolic Effects of Nebivolol During Maximal and Submaximal Exercise Performance

Abstract

This study compared the effects of clinically prescribed doses of atenolol, propranolol, diltiazem and a novel β1-selective antagonist, nebivolol, on maximal and submaximal exercise performance in physically active subjects. In a double-blind crossover trial, 11 healthy male volunteers performed progressive aerobic exercise to exhaustion for determination of maximal and submaximal oxygen consumption after subacute ingestion of atenolol, propranolol, nebivolol, diltiazem and placebo. Maximal oxygen consumption (VO2max), exercise time to exhaustion and peak workload were decreased by propranolol and atenolol (p < 0.05) vs placebo. Peak heart rate (p < 0.01) and submaximal systolic blood pressure (p < 0.05) were reduced by nebivolol, atenolol and propranolol vs placebo. There was no intergroup variation in peak submaximal minute ventilation, the peak respiratory exchange ratio, peak blood lactate concentrations and lactate accumulation with increase in work rate. Although there were no differences between drugs in submaximal oxygen consumption, minute ventilation and blood lactate concentrations, ratings of perceived exertion were increased on all 3 β-receptor antagonists during submaximal exercise. We conclude that nebivolol, atenolol and propranolol but not diltiazem lower systolic blood pressure during exercise. Maximal aerobic performance was impaired by atenolol and propranolol but not by nebivolol and diltiazem. Unlike other β-receptor antagonists, nebivolol lowered blood pressure and heart rate but did not appear to affect maximal aerobic exercise performance.