Beta-Blockade and Exercise in Normal Subjects and Patients With Coronary Artery Disease

In brief: Beta-blocking drugs are now? commonly used in patients with hypertension or coronary artery disease (CAD). This article reviews the effects of beta-blockade and recommends exercise prescriptions for patients taking these drugs. In patients with asymptomatic, uncomplicated hypertension, these medications impair exercise performance to some degree, especially endurance exercise or exercise lasting more than 30 minutes. Beta-blockers also hinder these patients' ability to improve performance with training. In patients with CAD and angina, however, exercise capacity often increases substantially because of improved angina control and the effects of peripheral conditioning. However, once their initial deconditioning has been overcome, their capacity for endurance exercise training may be impaired by the effects of beta-blockade on muscle metabolism. This effect may be lessened by the choice of a more cardioselective beta-blocking drug.