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Exercise Metabolism and β-Blocker Therapy

An Update

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Abstract

The rationale for the concurrent prescription of β-blockers and programmes of exercise is that both medication and physical activity can improve the quality of life of patients with cardiovascular disease. Difficulties arise when drugs reduce either the physical ability or the motivation to exercise. This article focuses on the physiological limitations to prolonged aerobic exercise in patients receiving β-blockers. Possible limiting factors to exercise while taking β-blockers include reduction in heart rate and cardiac output, local alterations to blood flow, changes to muscle and liver glycogenolysis, and alterations to adipose and intramuscular lipolysis.

The disadvantages and advantages of nonselective and β1-selective drugs are discussed, as well as those of drugs that have β2-agonist properties. Particular emphasis is placed upon the β-blocker-induced attenuation of the normal increase in fat oxidation during prolonged exercise. There are physiological advantages, especially for the physically active individual, in prescribing β1-selective rather than nonselective drugs in controlled release, rather than conventional release, form. Additionally, there may be further advantages in prescribing drugs which have partial agonist properties at β2 receptors.

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  1. Department of Sport Sciences, Brunel University, Osterley Campus, Isleworth, Middlesex, TW7 5DU, England

    Anthony Head

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Head, A. Exercise Metabolism and β-Blocker Therapy. Sports Med 27, 81–96 (1999). https://doi.org/10.2165/00007256-199927020-00002

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