Comparative effects of bisoprolol and nitrendipine on exercise capacity inhypertensive patients with regular physical activity

The aim of this study was to evaluate the long-term effects of administerin g bisoprolol compared with nitrendipine on the duration of the exercise tol erated by male and female patients, aged 18-65 years, having mild to modera te hypertension and taking regular exercise. In this double-blind, randomiz ed prospective study, 96 patients (85 men and 11 women, 48 +/- 10 years) fo rmed two groups: 49 in the bisoprolol group, and 47 in the nitrendipine gro up. After a washout period of 14 days, either 10 mg of bisoprolol or 20 mg of nitrendipine was given daily over a treatment period of 12 weeks. During the treatment period, the stability of the physical training was monitored weekly by using a questionnaire. The results of two maximal triangular exe rcise tolerance tests (ETTs) on an ergometric bicycle performed at D0 under placebo and at D84 under active treatment were compared. No statistical di fference was observed between both groups, concerning age, gender, morpholo gic characteristics, resting cardiovascular parameters, or physical trainin g. Both groups maintained the same training level throughout the study. No significant differences between the groups were noted for duration of ETT [ D0 892 +/- 284 s, D84, 919 +/- 267 s (NS) vs. D0 929 +/- 290 s, D84 904 +/- 324 s (NS)], or maximal work load [D0 190 +/- 49 W, D84 197 +/- 48 W (NS) vs. D0 198 +/- 49 W D84 196 +/- 55 W (NS)] On the other hand, both groups d iffered in maximal systolic blood pressure [D0 239 +/- 24 mm Hg, D84 215 +/ - 22 mm Hg (p < 0.001) vs. D0 237 +/- 24 mrn Hg, D84 222 +/- 27 mm Hg (p < 0.05)] (p = 0.05), and maximal pulse rate during exercise [141 +/- 18 vs. 1 63 +/- 17] (p < 0.001), albeit not in maximal diastolic blood pressure [D0 113 +/- 13 mm Hg, D84 106 +/- 17 mm Hg (p < 0.05) vs. D0 112 +/- 13 mm Hg, D84 104 +/- 15 mm Hg (p < 0.05)]. The patient's own perception of the maxim al effort (Borg scale) was not significantly different in either of the gro ups (placebo vs, treatment). Overall, in a population of hypertensive patie nts taking regular exercise, long-term treatment with bisoprolol produced n o significant changes in the duration of peak effort, maximal workload, or the effort perceived by the patients themselves. The effects of regular exe rcise were comparable in both groups (bisoprolol or nitrendipine). Because previous studies have shown that dihydropyridines do not modify exercise pe rformance in hypertensive patients, it may be concluded that the antihypert ensive therapy with bisoprolol is well tolerated in a population of active hypertensive patients during dynamic exercise.