[Aerobic training guidelines in beta blocker therapy. An update].

Beta adrenergic blockers are first choice drugs in patients treated for hypertension, coronary heart disease, and patients recovering from myocardial infarction. In addition, aerobic exercise per se has proven to cause beneficial effects on those health problems. However, beta adrenergic blockade significantly effects aerobic hemodynamics and metabolism. These tremendous changes have to be taken under consideration when prescribing aerobic exercise for therapeutic purposes. In general, the guidelines for exercise prescription used for patients taking beta adrenergic blockers are similar to those used for healthy individuals. The factor that is most discussed is how to calculate the exercise intensity. The monitoring of exercise intensity with heart rate is acceptable for use as long as exercise intensity is determined while patient is on similar doses of beta adrenergic blocker at the time of exercise testing. RPE (rate perceived exertion) as an adjunct to heart rate in monitoring exercise intensity should be used. Chronic beta adrenergic blocker therapy with exercise training will improve aerobic capacity (VO2max) in healthy and hypertensive individuals, but the magnitude of improvement of VO2max is attenuated (approximately 10%) if compared to patients, suffering from coronary heart disease or recovering from myocardial infarction (+30%). Chronic beta adrenergic blocker therapy with aerobic exercise does not result in the lipid profile being improved. However, exercise training may be responsible for attenuating the beta adrenergic blocker induced deterioration of lipid profile normally seen. Although small, there seems to be an advantage to selective beta adrenergic blocker therapy, when combined with exercise training.