SUMMARY The effect of the beta1 selective adrenoceptor blocker, atenolol, on the physiological response to exercise was studied in 12 healthy young men. Oral atenolol (100 mg) and placebo were administered in a randomised double blind crossover fashion an hour and a half before an intermittent multistage cycle ergometer exercise test. At maximal effort oxygen consumption, pulmonary ventilation, carbon dioxide output, and respiratory exchange ratio were not modified by atenolol. In contrast, maximal heart rate and performance time were significantly reduced after atenolol. Nevertheless, because the relation of percentage of maximal oxygen consumption to percentage of maximal heart rate was not changed by atenolol both the absolute and relative oxygen consumption corresponding to 70% and 85%h of the maximal heart rate remained unaltered.These data suggest that recommendations of exercise intensity may be determined on the basis of a calculated percentage of the predetermined maximal heart rate in persons without symptomatic coronary heart disease receiving beta1 selective adrenoceptor blockers.
We evaluated the effect of cholesterol reduction on atherosclerotic coronary artery lesions using diet and simvastatin, a potent HMG CoA reductase inhibitor. Fifteen subjects aged 28-69 years (mean 44), each of whom demonstrated significant (greater than 50%) narrowing of a coronary artery and a baseline cholesterol level greater than 278 mg/dl, were studied. Coronary arteriography was performed prior to and after 20 +/- 2.5 months of therapy. A 42% reduction in total serum cholesterol, a 52% reduction in LDL cholesterol, and an 87% increase in the HDL/LDL cholesterol ratio (p less than 0.01) were achieved. Pretreatment and posttreatment angiograms were reviewed by three experienced angiographers with temporal order masked. Improvement in the overall status of coronary atherosclerotic lesions was demonstrated in two patients (13%), while deterioration occurred in one patient (7%). No overall change was found in the remaining 12 patients (80%). We conclude that a cholesterol-lowering regimen using a nonatherogenic diet and simvastatin therapy may at least stabilize coronary atherosclerosis.
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