EFFECT OF BETA-BLOCKADE ON EXERCISE CAPACITY IN HYPERTENSIVE SUBJECTS- A ONE-YEAR DOUBLE-BLIND-STUDY OF CELIPROLOL AND METOPROLOL

To assess the effect of beta-blocker antihypertensive therapy on exerc ise capacity, 40 patients randomized to celiprolol 200 mg and metoprol ol 100 mg daily in a double-blind fashion were studied after a month o f placebo and a year of active treatment. Both drugs normalized office blood pressure and produced echocardiographic and electrocardiographi c left ventricular hypertrophy regression. In symptom-limited maximal stress tests before and after treatment, exercise duration increased w ith (p < 0.0001) celiprolol (513-700 seconds) and metoprolol (520-634 seconds), although more with the former (p = 0.02). Resting heart rate was reduced with both, more with metoprolol (p < 0.001), while heart rate at peak exercise was reduced similarly with both medications (p < 0.005). Blood pressure at peak exercise was reduced with both celipro lol (217-184 mmHg; p = 0.0002) and metoprolol (218-185 mmHg, p < 0.000 1) to a similar degree (p = NS). Exercise parameters were not related to patient age or the degree of left ventricular hypertrophy regressio n (p = NS). It is concluded that beta-blocker antihypertensive therapy improves exercise capacity, decreasing heart rate and blood pressure responses to stress, irrespective of left ventricular structural chang es.