Effect of β-Blocking Drugs on Peripheral Blood Flow in Intermittent Claudication

Chronic effects of metoprolol and methyldopa on calf blood flow in intermittent claudication.

“…There is evidence to suggest that this problem is related to decreased muscle perfusion due to diminished blood pressure caused by reduction in cardiac output (Trap-Jensen et al, 1975;Lepantalo & Totterman, 1983) rather than to blockade of 82-adrenoceptors in peripheral vasculature (Kendall, 1981). Regardless the presence of 8I-selectivity or intrinsic sympathomimetic activity, all /3-adrenoceptor blockers seemed to decrease the mean exercise muscle blood flow in patients with intermittent claudication (Smith & Warren, 1982).…”

Walking capacity of patients with intermittent claudication during chronic antihypertensive treatment with metoprolol and methyldopa

“…A reduction in calf blood flow at maximum vasodilatation is observed during chronic beta-adrenoceptor blockade both in hypertensive patients with intermittent claudication (Ingram et al, Smith & Warren, 1982) and in patients with hypertension only (Trap-Jensen et al, 1975;Lepantalo & Totterman, 1983). The flow reduction during chronic beta-adrenoceptor blockade is the probably cause of exacerbation of intermittent claudication in the few patients reported in the literature (Conway, 1975;Rodger et af., 1976;Zacharias, 1976;Vale & Jefferys, 1978;Fogoros, 1980).…”

Beta‐adrenoceptor partial agonists: a renaissance in cardiovascular therapy?

“…In some patients, I-adrenoceptor blockers have adverse effects on the peripheral circulation leading to cold peripheries (Marshall et al, 1976) or exacerbation of intermittent claudication (Rodger et al, 1976;Smith & Warren, 1982). Both a fall in cardiac output which leads to a reflex peripheral vasoconstriction, and a loss of P2-adrenoceptor mediated vasodilatation in skeletal muscle in the case of non-selective drugs may contribute to these problems.…”