1 Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
2 Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
J Cardiovasc Pharmacol Ther. 2019 Jan;24(1):37-45. doi: 10.1177/1074248418778551. Epub 2018 May 24.
β-Blockers (BBs) have been associated with a reduced cardiorespiratory fitness (CRF). This is possibly caused by inhibition of β2-receptors in the airways. However, there are limited data available on β-receptor selectivity and CRF. We therefore aimed to assess the association between BB use and CRF and to assess the association between β-receptor selectivity and CRF.
Participants in the Maastricht Study were aged between 40 and 75 years. Exposure to BB use was determined by use of pharmacy records. General linear models were used to obtain adjusted means of 2 proxies for CRF: covered distance during the 6-minute walk test (6MWT) and estimated maximum power output adjusted for body mass ( W kg) during the submaximal cycle ergometer test. Adjusted means were compared between current, past, and never BB users. Current users were subsequently stratified by β-receptor selectivity and dose.
Compared to never use, current use was associated with a lower CRF, based on the 6MWT (current use: 569.7 m; never use: 580.4 m [ P = .010]), but not based on the cycling test (current use: 2.14 W kg; never use: 2.13 W kg [ P = .690]). There was no difference between current selective and current nonselective BB use.
β-Blockers use was associated with CRF based on the 6MWT but not the cycling test. There was no difference between current selective and nonselective BB users, possibly due to the small number of nonselective BB users, differential underlying diseases, other pharmacological properties, and limitations related to the proxies of the outcome.
β-受体阻滞剂(BBs)与心肺功能(CRF)降低有关。这可能是由于气道中β2-受体的抑制。然而,关于β受体选择性与 CRF 的相关数据有限。因此,我们旨在评估 BB 使用与 CRF 之间的关联,并评估β受体选择性与 CRF 之间的关联。
Maastricht 研究的参与者年龄在 40 至 75 岁之间。通过使用药房记录来确定 BB 使用的暴露情况。使用一般线性模型获得 2 个 CRF 替代指标的调整平均值:6 分钟步行试验(6MWT)期间的覆盖距离和亚最大功率输出调整为体重(W/kg)的估计最大值在次最大的自行车测力计测试期间。比较当前、过去和从未使用 BB 的参与者的调整平均值。随后根据β受体选择性和剂量对当前使用者进行分层。
与从未使用相比,当前使用与较低的 CRF 相关,基于 6MWT(当前使用:569.7 m;从未使用:580.4 m[P =.010]),但基于自行车测试则不然(当前使用:2.14 W/kg;从未使用:2.13 W/kg[P =.690])。当前选择性和当前非选择性 BB 使用之间没有差异。
β-受体阻滞剂的使用与基于 6MWT 的 CRF 相关,但与自行车测试无关。当前选择性和非选择性 BB 用户之间没有差异,这可能是由于非选择性 BB 用户数量较少、潜在疾病不同、其他药理学特性以及与结果替代物相关的限制。