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Effect ofβ-adrenergic blockade on haemodynamic responses to dynamic and isometric exercise in angina pectoris


The effect of treatment for 1–4 weeks with metoprolol, a β1-selective blocking agent, or alprenolol, on the heart rate and blood pressure response to isometric exercise was studied in two groups of 12 patients with angina. Measurements were made during the peak effect of metoprolol 10, 40 or 50 mg, and alprenolol 200 mg as Aptin® Durules®. After 1 min of sustained handgrip at 50% of maximal voluntary contraction, systolic (6–15%) and diastolic (8–12%) blood pressure after both drugs was significantly lower than without any β-blockade; Heart rate was decreased by 19–22% by metoprolol but not by alprenolol. The blood pressurerise during handgrip was not attenuated by either drug. The rise in heart rate was significantly reduced (by 36–50%) by metoprolol 40 and 50 mg and alprenolol 200 mg. No patient experienced angina during handgrip. In contrast, all but one were restricted by angina during bicycle exercise without treatment, at a level that produced the same increase in heart rate as the handgrip test, viz. 3 min at a load of 33 W). The cardiovascular response to sustained handgrip is too small to provide a useful challenge for determination of the anti-anginal efficacy of drugs. However, slight ECG changes of ischaemia did occur during handgrip, which were reversed by β-blockade.

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  1. 1.

    Comerford, M. B., Besterman, E. M. M.: An eighteen months' study of the clinical response to metoprolol, a selective β1-receptor blocking agent, in patients with angina pectoris. Postgrad. Med. J.52, 481–486 (1976)

  2. 2.

    Dunnett, C. W.: In: Selected Pharmacological Testing Methods. A. Burger (ed.), p. 23. New York: Marcel Dekker 1968

  3. 3.

    Ekelund, L.-G., Olsson, A. G., Orö, L., Rössner, S.: Effects of the cardioselective beta-adrenergic receptor blocking agent metoprolol in angina pectoris. Subacute study with exercise tests. Br. Heart J.38, 155–161 (1976)

  4. 4.

    Freyschuss, U.: Cardiovascular adjustment ot somatomotor activation. Acta Physiol. Scand. [Suppl.]79 1–63 (1970)

  5. 5.

    Hagman, M., Jönsson, D., Wilhelmsen, L.: Prevalence of angina pectoris and myocardial infarction in a general population sample of Swedish men. Acte Med. Scand.201, 571–577 (1977)

  6. 6.

    Haissly, J.-C., Messin, R., Degre, S., Vandermoten, P., Demaret, B., Denolin, H.: Comparative response to isometric (static) and dynamic exercise tests in coronary disease. Am. J. Cardiol.33, 791–796 (1974)

  7. 7.

    Kjellberg, S. R., Rudhe, U., Sjöstrand, T.: The relation of the cardiac volume to the weight and surface area of the body, the blood volume and the physical capacity for work. Acta Radiol. Stockh.31, 113–122 (1949)

  8. 8.

    Kozlowski, S., Brzezinska, Z., Nazar, K., Kowalski, W., Franczyk, M.: Plasma catecholamines during sustained isometric exercise. Clin. Sci. Mol. Med.45, 723–731 (1973)

  9. 9.

    Ljung, B., Åblad, B., Drews, L., Fellenius, E., Kjellstedt, A., Wallborg, M.: Antihypertensive effect of metoprolol in spontaneously hypertensive rats. Clin. Sci. Mol. Med.51, 443–445 (1976)

  10. 10.

    Martin, C. E., Shaver, J. A., Leon, D. F., Thompson, M. E., Reddy, P. S., Leonard, J. J.: Autonomic mechanisms in haemodynamic responses to isometric exercise. J. Clin. Invest.54, 104–115 (1974)

  11. 11.

    Nyberg, G.: Methodological aspects on drug testing in angina pectoris. Diss. Göteborg Tre Punkter AB 1973

  12. 12.

    Nyberg, G.: Blood pressure and heart rate response to isometric exercise and mental arithmetic in normotensive and hypertensive subjects. Clin. Sci. Mol. Med.51, Suppl. 3 (1976a, 681–685

  13. 13.

    Nyberg, G.: Effect of β-blockers on heart rate and blood pressure in dynamic and isometric exercise. Drugs11, 185–195 (1976b)

  14. 14.

    Nyberg, G.: Effects on heart rate and blood pressure of sublingual nitroglycerin at rest and during sustained handgrip in patients with arterial hypertension. Curr. Ther. Res.23, 306–311 (1978)

  15. 15.

    Nyberg, G., Vedin, A., Wilhelmsson, C.: Heart rate and blood pressure response to isometric exercise after sublingual nitroglycerine in hypertensive male subjects: a controlled study of propranolol and labetalol for two weeks. Curr. Ther. Res.25, 400–405 (1979)

  16. 16.

    Nyberg, G.: Effects of beta-receptor antagonists (metoprolol, pindolol), beta2-receptor agonist (terbutaline) and nitroglycerine (sublingual and oral slow-release) on the blood pressure reaction during isometric exercise in patients with angina pectoris. Curr. Ther. Res.25, 389–399 (1979)

  17. 17.

    Robson, R. H., Fluck, D. C.: Autonomic blockade and coronary catecholamines and cyclic-AMP in exercising man. J. Appl. Physiol.43, 949–952 (1977)

  18. 18.

    Robson, R. H., Fluck, D. C.: Effect of submaximal isometric exercise on catecholamine, cAMP and lactate concentrations in the coronary circulation in man, following atropine and oxprenolol. Cardiology63, 280–286 (1978)

  19. 19.

    Siegel, S.: Non-parametric statistics for the behaviourial sciences. New York: McGraw-Hill 1956

  20. 20.

    Simoons, M. L., Hugenholtz, P. G.: Estimation of the probability of exercise-induced ischemia by quantitative ECG analysis. Circulation56, 552–558 (1977)

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Nyberg, G. Effect ofβ-adrenergic blockade on haemodynamic responses to dynamic and isometric exercise in angina pectoris. Eur J Clin Pharmacol 15, 381–388 (1979).

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Key words

  • angina pectoris
  • metoprolol
  • alprenolol
  • exercise
  • ECG changes
  • haemodynamic parameters