Effects of Short-Term and Long-Term Treatment with Cardio-Selective and non-Selective β-Receptor Blockade on Carbohydrate and Lipid Metabolism and on Plasma Catecholamines at Rest and during Exercise

Abstract

1. The effects on glucose and lipid metabolism and on plasma catecholamines at rest and during exercise, of 4 weeks treatment with non-selective beta-blockade (pindolol, 15 mg daily) and with cardio-selective blockade (metoprolol, 200 mg, and acebutolol, 500 mg, respectively) were compared in different groups of hypertensive men (mean age 37 years) by single blind cross-over technique. All patients continued the treatment with either metoprolol or acebutolol for another 12--14 months. 2. All antagonists reduced blood pressures and exercise heart rates in a virtually identical manner. Whereas lipolysis was similarly inhibited by both selective beta 1-antagonists and non-selective beta 1-beta 2-blockers, glycogenolysis in the muscle was inhibited only by non-selective beta-receptor blockade. 3. The inhibition of glycogen breakdown resulted in exercise hypoglycaemia and in increases of plasma adrenaline and ACTH, which probably reflect counter-regulatory mechanisms. No major metabolic changes occurred after 12--14 months compared with 4 weeks of treatment.

Bisoprolol pharmacokinetics and body composition in patients with chronic heart failure: a longitudinal study

“…In our group of patients, no significant rise in total body weight was observed at the follow-up visit, but there was a significant increase in fat mass and percentage fat mass ( Table 2). A similar observation was reported previously as a general effect of BBs and could be due to inhibition of lipolysis [30,31].…”

Effects of cardioselective and nonselective beta-adrenergic blockade on the performance of highly trained runners

“…(11) He She completed Stages (12) for a total of (13) minutes. The peak heart rate attained was (14) beats per minute, which is (15) % of the maximum predicted heart rate for a person of this age and fitness level.…”

Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

“…Energy efficiency is reduced due to enhanced free fatty acid availability and suppressed glucose metabolism [18,19]. The potential mechanisms involved in the beta blockers associated weight gain include reduced basal metabolic rate [20], reduced thermogenic response [21,22], and inhibition of lipolysis [23] which might be drug dependent. A recent study in non-cachectic CHF patients treated with carvedilol and bisoprolol demonstrated reduction of total body resting energy production rate while only carvedilol has been shown to shift substrate utilization from lipid to glucose metabolism [24].…”