Beta-blocker use reduces daily physical activity

Treatment with beta-blockers in hypertension may decrease daily physical activity but not maximal exercise performance, a study has found.

A team of investigators assessed daily physical activity and maximal exercise performance in 56 patients with hypertension (grade I‒II), with and without beta-blockers (bisoprolol 10 mg or atenolol 100 mg) added to standard treatment. Of these, 48 completed the study.

The investigators also performed tests after 8 weeks of antihypertensive therapy without beta-blockers and after the following 8 weeks with beta-blockers.

Differences between beta-blockers were not significant. At office measurement, beta-blockers reduced heart rate from 78 to 62 bpm (p<0.01) and systolic blood pressure (SBP) from 133 to 125 mm Hg (p<0.01). No significant changes were seen for diastolic blood pressure (DBP). On the other hand, ambulatory pressure monitoring DBP, but not SBP, decreased with beta-blockers (mean 24-h DBP 77 vs 74 mm Hg; p<0.01).

Using a portable armband device, the participants recorded an overall reduction in daily activities and in estimated kilocalories consumption. Beta-blockers reduced time with activity more than 3 metabolic equivalent of tasks (METs) from 148.1 to 117.9 min (p<0.01). In addition, cardiopulmonary exercise showed a preserved exercise performance not affected by beta-blockers.

“In hypertension, beta-blockers have a high rate of nonadherence to treatment likely because of fatigue,” the investigators said.