Effects of propranolol and metoprolol on haemodynamic and respiratory indices and on perceived exertion during exercise in hypertensive patients.

Herwaarden, C L van; Binkhorst, R. A.; Fennis, J.F.M.; Laar, A. Van't

doi:10.1136/hrt.41.1.99

Cited by 48 publications

(16 citation statements)

References 30 publications

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“…35 These factors might partly explain why post-MIs reported higher RPE values during both protocols, though there was no difference in RER or VO 2 values between groups. It has been reported that β-blockers do not affect RPE in clinical groups36–38 and do not tend to influence unless exercise is longer than 60 min and/or at an intensity higher than 65% VO 2 max 3031 This exercise intensity would most likely have been achieved during the latter stages of either MSWT protocol and might therefore explain the heteroscedasticity observed in RPE between groups (see figure 6).…”

Section: Discussionmentioning

confidence: 91%

Exploring adaptations to the modified shuttle walking test

Woolf-May

Meadows

2013

BMJ Open

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ObjectiveThe 10 m modified shuttle walking test (MSWT) is recommended to determine the functional capacity in older individuals and for patients entering cardiac rehabilitation. Participants are required to negotiate around cones set 1 m from the end markers. However, consistent comments indicate that for some individuals manoeuvring around the cones can be quite difficult. Therefore, the objective of this study was to explore differences within and between non-cardiac and postmyocardial infarction (MI) males during MSWT with and without the cones.DesignComparative study.Participants20 post-MI (64.8±6.6, range 51–74 years) and 20 non-cardiac male controls (64.1±5.7, range 52–74 years) participated.MethodsParticipants performed MSWT with and without cones. Throughout, the participants expired air, and the heart rate (bpm) (HR) and ratings of perceived exertion (RPE) were measured. Participant protocol preference was recorded verbatim.ResultsOne-way analysis of variance found no significant difference in VO2 peak (cones 20.4±5.1 vs no-cones 21.9±4.8 ml/kg/min, p=0.197) or distance ambulated (cones 631.8±132.9 m vs no-cones 662.4±164.1 m, p=0.371) between protocols or groups. Analysis comparing lines of regression showed a significant trajectory difference in VO2 (ml/kg/min) (p<0.01) between protocols with higher HR (p<0.01) and respiratory exchange ratio (RER, p<0.001) values during cones. RPEs were higher for post-MIs versus controls during both protocols (p<0.05). Post-MIs taking β-blockers produce significantly lower HR values. The χ2 analysis found no significant difference in protocol preference (no-cones: all n=25, 63%; post-MIs n=13, 65%; and controls n=12, 60%).ConclusionsPost-MIs found both protocols subjectively harder than controls with no significant difference in the VO2 peak. However, both groups worked at a lesser percentage of their anaerobic threshold during no-cones protocol as indicated by lower RER values. Importantly, for the post-MIs, this would reduce their risk of functional impairment. Therefore, though more research is required, indicators at present are more favourable for the use of the no-cones with post-MIs.

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Section: Discussionmentioning

confidence: 91%

Exploring adaptations to the modified shuttle walking test

Woolf-May

Meadows

2013

BMJ Open

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“…For these individuals, due to the blunting of normal heart rate response by b blockers, VO 2 max cannot be predicted from the present CST procedure. However, because it is known that at intensities ,65%VO 2 max, the relation between RPE and work rate is unaltered by b blockade, [9][10][11][12] this may still allow the CST to show an improvement in fitness from reductions in heart and RPE for a given CST stage.…”

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confidence: 99%

Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise

et al. 2004

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Objectives: To evaluate the reliability and validity of measures taken during the Chester step test (CST) used to predict VO 2 max and prescribe subsequent exercise. Methods: The CST was performed twice on separate days by 7 males and 6 females aged 22.4 (SD 4.6) years. Heart rate (HR), ratings of perceived exertion (RPE), and oxygen uptake (VO 2 ) were measured at each stage of the CST. Results: RPE, HR, and actual VO 2 were the same at each stage for both trials but each of these measures was significantly different between CST stages (p,0.0005). Intertrial bias ¡95% limits of agreement (95% LoA) of HR reached acceptable limits at CST stage IV (22¡10 beats/min) and for RPE at stages III (0.2¡1.4) and IV (0.5¡1.9). Age estimated HRmax significantly overestimated actual HRmax of 5 beats/min (p = 0.016) and the 95% LoA showed that this error could range from an underestimation of 17 beats/min to an overestimation of 7 beats/min. Estimated versus actual VO 2 at each CST stage during both trials showed errors ranging between 11% and 19%. Trial 1 underestimated actual VO 2 max by 2.8 ml/kg/min (p = 0.006) and trial 2 by 1.6 ml/kg/min (not significant). The intertrial agreement in predicted VO 2 max was relatively narrow with a bias ¡95% LoA of 20.8¡3.7 ml/kg/min. The RPE and %HRmax (actual) correlation improved with a second trial. At all CST stages in trial 2 RPE:%HRmax coefficients were significant with the highest correlations at CST stages III (r = 0.78) and IV (r = 0.84). Conclusion: CST VO 2 max prediction validity is questioned but the CST is reliable on a test-retest basis. VO 2 max prediction error is due more to VO 2 estimation error at each CST stage compared with error in age estimated HRmax. The HR/RPE relation at .50% VO 2 max reliably represents the recommended intensity for developing cardiorespiratory fitness, but only when a practice trial of the CST is first performed.T he Chester step test (CST) was originally developed by Kevin Sykes at University College Chester to assess aerobic fitness by predicting maximal aerobic power (VO 2 max) in fire brigades in Britain, Europe, USA, and Asia, and more recently for work with airport firefighters, the ambulance service, health authorities, and corporate institutions.1 It also features in commercial health and fitness assessment packages and most noticeably one in particular (Fitech Pty Ltd, Australia; www.fitech.com.au). The CST is one of many tests designed to provide a safe and practical means of assessing aerobic fitness under submaximal conditions. Examples of other similar tests include the Astrand-Ryhming nomogram cycle ergometer protocol, 2 the American College of Sports Medicine protocols for cycle ergometry and treadmill, 3 and the Canadian standardised step test of fitness. 4 The limited equipment needed (step, heart rate monitor, portable cassette or compact disk player, and perceived exertion scale) makes the CST very portable and requirements for space are minimal, which is advantageous compared with similar protocols using treadmills, shutt...

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“…The pattern of pressor responses was no different in the presence of selective or nonselective 1-blockade (Van Herwaarden et al, 1979;Morrison et al, 1982). Thus, the latter were consistent with predominantly neurogenic (noradrenaline mediated) stimulation and widespread vasoconstriction.…”

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confidence: 66%

Are blood pressure surges associated with sympathetic stimulation aggravated by beta-adrenoceptor antagonist treatment?

Kumana¹

1986

Postgraduate Medical Journal

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Patterns of sympathetically mediated acute pressor responsesThe classical work of Goldenberg et al. (1948) and Barcroft & Starr (1952) in healthy volunteers, demonstrated that intravenous (i.v.) infusion of adrenaline (over 5-35 minutes) reduced diastolic blood pressure and peripheral resistance (a,-receptor mediated vasoconstriction being more than balanced out by R2-receptor mediated vasodilatation), but increased systolic pressure and heart rate (fl-receptor mediated and reflex effects). By contrast, noradrenaline infusion increased peripheral resistance, diastolic and systolic pressure (a-receptor mediated vasoconstriction) and reduced heart rate (reflexly). During prolonged (1 hour) catecholamine infusions, however, feedback through presynaptic P (facilitatory) and a2 (inhibitory) receptors may become evident (Brown et al., 1985) and greatly complicate the resultant haemodynamic response.Theoretical concerns, that antagonism ofP-receptor mediated vasodilatation might elevate blood pressure in sustained hypertension, were eventually refuted. However, Prichard & Ross (1966) demonstrated, in phaeochromocytoma patients pretreated with phenoxybenzamine, increases in lying and standing systolic and diastolic blood pressure lasting about 8 hours after single 80 mg doses of oral propranolol. Presumably, P-receptor mediated vasodilatation due to circulating adrenaline was antagonized, thus unmasking a-receptor mediated vasoconstriction leading to increased peripheral resistance and venoconstriction.

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Effects of propranolol and metoprolol on haemodynamic and respiratory indices and on perceived exertion during exercise in hypertensive patients.

Cited by 48 publications

References 30 publications

Exploring adaptations to the modified shuttle walking test

Exploring adaptations to the modified shuttle walking test

Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise

Are blood pressure surges associated with sympathetic stimulation aggravated by beta-adrenoceptor antagonist treatment?

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