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Reduced ambulatory heart rate response to physical work and complaints of fatigue among hypertensive males treated with beta-blockers

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Abstract

Treatment with beta-blockers affects oxygen metabolism and lipolysis during physical exertion. Together with possible central nervous system effects, this may impair the work capacity of treated hypertensive subjects. In a study of 1619 male employees, aged 45–64 years, mean resting and ambulatory heart rate (HR) and complaints of fatigue were compared between hypertensive workers treated with beta-blockers and untreated hypertensives and normotensives under low and high workload conditions. Treated hypertensives had lower mean resting HRs compared with normotensives and untreated hypertensives. Their change from resting to ambulatory HR during low and high workload was also lower than normotensives and untreated hypertensives, and they had higher fatigue scores than their untreated counterparts at both workload levels. The highest fatigue score was reported by treated subjects under high workload. These findings demonstrate a reduced HR response to physical work accompanied by more symptoms of fatigue during treatment with beta-blockers. When hypertensives are engaged in physically demanding work, other classes of antihypertensive therapy should be considered.

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References

  • Akselrod, S., Norymberg, M., Peled, I., Karabelnik, E., and Green, M. S. (1987). Computerized analysis of ST segment changes in ambulatory electrocardiograms.Med. Biol. Eng. Comput. 25: 513–519.

    PubMed  Google Scholar 

  • Astrand, I. (1960). Aerobic work capacity in men and women with special reference to age.Acta Physiol. Scand. 49 (Suppl. 169): 1–92.

    Google Scholar 

  • Astrand, I. (1967). Degree of strain during building work as related to individual aerobic work capacity.Ergonomics 10: 293–296.

    PubMed  Google Scholar 

  • Astrand, P. O., and Rodahl, K. (1977) Physical work capacity. In Black, N. W. and Belser, J. R. (eds.),Textbook of Work Physiology. Physiological Bases of Exercise, McGraw-Hill, New York, pp. 289–326.

    Google Scholar 

  • Astrand, P. O., and Rodahl, K. (1977).Textbook of Work Physiology (2nd ed.). McGraw-Hill, New York.

    Google Scholar 

  • Bauman, J. L., Cameron, D. L., Zimmerman, S. R., and Leventhal, H. (1989). Illness representations and matching labels with symptoms.Health Psychol. 8: 449–464.

    PubMed  Google Scholar 

  • Bruce, R. T., Hossack, K. F., Kusumi, F., and Clarke, L. J. (1979). Acute effects of oral propranolol on hemodynamic responses to upright exercise.Am. J. Cardiol. 44: 132–140.

    PubMed  Google Scholar 

  • Caldwell, J. E., Ahonen, E., and Nousiainen, U. (1984). Differential effects of sauna-, diuretic-, and exercise-induced hypohydration.J. Appl. Physiol. 57: 1018–1023.

    PubMed  Google Scholar 

  • Danzinger, R. G., and Cumming, S. R. (1964). Effects of chlorothiazide on working capacity of normal subjects.J. Appl. Physiol. 19: 636–638.

    PubMed  Google Scholar 

  • Epstein, S. E., Robinson, B. F., Kahler, R. L., and Braunwald, E. (1965). Effects of beta-adrenergic blockade on the cardiac response to maximal and submaximal exercise in man.J. Clin. Invest. 44: 1745–1753.

    PubMed  Google Scholar 

  • Franciosa, J. A., Johnson, S. M., and Tobian, L. J. (1980). Exercise performance in mildly hypertensive patients.Chest 78: 291–299.

    PubMed  Google Scholar 

  • Galbo, H., Holst, J. J., Christensen, N. J., and Hilsted, J. (1976). Glucagon and plasma catecholamines during beta-receptor blockade in exercising man.J. Appl. Physiol. 40: 855–863.

    PubMed  Google Scholar 

  • Gordon, N. F., Van Rensburg, J. P., Russell, H. M. S., Kawalsky, D. L., Celliers, C. P., et al. (1985). Effects of betal selective adrenoceptor blockade on physiological response to exercise.Br. Heart J. 54: 96–99.

    PubMed  Google Scholar 

  • Gordon, N. F., Van Rensburg, J. P., Van den Heever, D. P., Kalliatakis, N. B., and Myburgh, D. P. (1987). Effect of dual beta blockade and calcium antagonism on endurance performance.Med. Sci. Sports Exercise 19: 1–6.

    Google Scholar 

  • Green, M. S., and Peled, I. (1992). Prevalence and control of hypertension in a large cohort of occupationally active Israelis examined during 1985–1987—the CORDIS study.Int. J. Epidemiol. 21: 676–682.

    PubMed  Google Scholar 

  • Gullestad, L., Dolva L. O., Aase, O., and Kjekshus, J. (1989). Interaction of naloxone and timolol on maximal exercise capacity and the subjective perception of fatigue.Int. J. Sports Med. 10: 259–263.

    PubMed  Google Scholar 

  • Kristal-Boneh, E., Melamed, S., Harari, G., and Green, M. S. (1995). Acute and chronic effects of noise exposure on blood pressure and heart rate among industrial employees—The CORDIS study.Arch. Environ. Health (in press).

  • Hossack, K. F., Bruce, R. A., and Clarke, L. J. (1980). Influence of propranolol on exercise prescription of training HRs.Cardiology 65: 47–58.

    PubMed  Google Scholar 

  • Hughson, R. L. (1984). Alterations in the oxygen deficit-oxygen debt relationships with beta-adrenergic receptor blockade in man.J. Physiol. 349: 365–387.

    Google Scholar 

  • Joyner, M. J., Freund, B. J., Jilka, S. M., et al. (1986). Effects of beta-blockade on exercise capacity of trained and untrained men: A hemodynamic comparison.J. Appl. Physiol. 60: 1429–1434.

    PubMed  Google Scholar 

  • Kowalchuk, L., and Hughson, R. L. (1990). Effect of beta-adrenergic blockade on VO2 kinetics during pseudorandom binary sequence exercise.Eur. J. Appl. Physiol. 60: 365–369.

    Google Scholar 

  • Lund-Johansen, P. (1974). Hemodynamic changes at rest and during exercise in long term beta-blocker therapy of essential hypertension.Acta Med. Scand. 195: 117–121.

    PubMed  Google Scholar 

  • Lundborg, P., Astrom, H., Bengtsson, C., et al. (1981). Effects of beta-adrenoceptor blockade on exercise performance and metabolism.Clin. Sci. 61: 299–305.

    PubMed  Google Scholar 

  • Luz, J., Melamed, S., Najenson, T., Bar, N., and Green, M. S. (1990). The structured ergonomic stress level (E-S-L) index as a predictor of accident and sick leave among male industrial employees. Proceedings of the fourth International Conference on Combined Effects of Environmental Factors-ICCEF 90, Baltimore MD.

  • Manenica, I. (1981). Physiological and work study assessment of physical work load. In Corlett, E. N., and Richardson, J. (eds.).Stress, Work Design, and Productivity. Wiley, Chichester.

    Google Scholar 

  • Reybrouck, T., Amery, A., Fagard, R., and Billiet, L. (1977). Hemodynamic response to graded exercise during chronic beta-adrenergic blockade with bunitrolol, an agent with intrinsic sympathomimetic activity.Eur. J. Clin. Pharmacol. 12: 333–339.

    PubMed  Google Scholar 

  • SAS Institute Inc. (1989).SAS Language: Reference, SAS Institute Inc., Cary, NC.

    Google Scholar 

  • Scruggs, K. D., Martin, N. B., Broeder, C. E., et al. (1991). Stroke volume during submaximal exercise in endurance-trained normotensive subjects and in untrained hypertensive subjects with beta blockade (propranolol and pindolol).Am. J. Cardiol. 67: 416–421.

    PubMed  Google Scholar 

  • Smith, U. (1983). Adrenergic control of lipid metabolism.Acta Med. Scand. 672: 41–47.

    Google Scholar 

  • Stoudemire, A., Brown, J. T., Harris, et al. (1984). Propranolol and depression: A reevaluation based on a pilot clinical trial.Psychol. Med. 2: 211–218.

    Google Scholar 

  • van Baak, M. A. (1988). Beta-adrenoceptor blockade and exercise. An update.Sports Med. 4: 209–225.

    Google Scholar 

  • van Baak, M. A., Jennen, W., and Verstappen, F. T. J. (1985). Maximal aerobic power and blood pressure in normotensive subjects after acute and chronic administration of metoprolol.Eur. J. Clin. Pharmacol. 28: 143–148.

    PubMed  Google Scholar 

  • Yudofsky, S. C. (1992). Beta-blockers and depression. The clinician's dilemma.JAMA 267: 1826–1827.

    PubMed  Google Scholar 

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This study was supported by the Committee for Preventive Action and Research in Occupational Health, The Ministry of Labor and Social Affairs, Jerusalem, Israel.

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Kristal-Boneh, E., Melamed, S., Bernheim, J. et al. Reduced ambulatory heart rate response to physical work and complaints of fatigue among hypertensive males treated with beta-blockers. J Behav Med 18, 113–126 (1995). https://doi.org/10.1007/BF01857864

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