Effect of beta-adrenoreceptor blockers on heart rate and blood pressure in dynamic and isometric exercise.

Abstract

Previous studies on the effects on heart rate and blood pressure in normals and hypertensive patients during dynamic exercise (ergometer bicycling or treadmill walking) and isometric exercise (sustained handgrip) are reviewed. In one study utilising sub-maximal bicycle exercise in hypertensives, there was a 43% increase in heart rate for a 33% increase in systolic pressure and 5% fall in diastolic pressure. Beta-adrenoreceptor blockade decreased the heart rate level by 18 to 19% for a decrease of systolic blood pressure level by 4 to 11%, whereas the diastolic pressure level was unaffected. A protocol is described utilising a blind indirect blood pressure recording machine ("Auto-Manometer") with which cuff inflation and deflation are automatic and constant, and blood pressure values stored at suitable Korotkov sound phases. The machine also records heart rate. By this method, isometric exercise at 50% of maximal voluntary contraction (sustained handgrip) has been studied in normals and hypertensives off and on different treatments. Both in normals and established hypertensives, there was about a 25% increase in systolic blood pressure during isometric exercise for about a 22% increase in diastolic blood pressure, and 26% increase in heart rate. Normotensive women had the lowest rise in blood pressure and the highest rise in heart rate. Beta-Adrenoreceptor blocking agents lowered heart rate during isometric exercise by 15 to 20% but did not affect the blood pressure level. Since resting blood pressure levels were decreased, the percentage rise in pressure was enhanced following beta-blockers. A combination of a beta-blocker, clonidine and/or a vasodilator produced a reduction in both systolic (24%) and diastolic (12%) pressure, as well as in heart rate (18%), during isometric exercise.