Vyssoulis G P, Kouremetis M T, Valiouli M A, Michaelides A P, Toutouzas P K
Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Greece.
Cardiovasc Drugs Ther. 1995 Feb;9(1):133-9. doi: 10.1007/BF00877753.
To assess the effect of beta-blocker antihypertensive therapy on exercise capacity, 40 patients randomized to celiprolol 200 mg and metoprolol 100 mg daily in a double-blind fashion were studied after a month of placebo and a year of active treatment. Both drugs normalized office blood pressure and produced echocardiographic and electrocardiographic left ventricular hypertrophy regression. In symptom-limited maximal stress tests before and after treatment, exercise duration increased with (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 celiprolol (217-184 mmHg; p = 0.0002) and metoprolol (218-185 mmHg, p < 0.0001) to a similar degree (p = NS). Exercise parameters were not related to patient age or the degree of left ventricular hypertrophy regression (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 changes.
为评估β受体阻滞剂抗高血压治疗对运动能力的影响，我们对40例患者进行了研究。这些患者以双盲方式随机分为两组，分别每日服用200毫克塞利洛尔和100毫克美托洛尔，在经过一个月的安慰剂治疗和一年的积极治疗后进行观察。两种药物均使诊室血压恢复正常，并使超声心动图和心电图显示的左心室肥厚消退。在治疗前后的症状限制最大应激试验中，塞利洛尔组（从513秒增至700秒）和美托洛尔组（从520秒增至634秒）的运动持续时间均增加（p < 0.0001），不过塞利洛尔组增加得更多（p = 0.02）。两种药物均使静息心率降低，美托洛尔组降低得更多（p < 0.001），而两种药物使运动峰值心率的降低程度相似（p < 0.005）。塞利洛尔（从217 mmHg降至184 mmHg；p = 0.0002）和美托洛尔（从218 mmHg降至185 mmHg，p < 0.0001）使运动峰值血压降低的程度相似（p = 无显著差异）。运动参数与患者年龄或左心室肥厚消退程度无关（p = 无显著差异）。结论是，β受体阻滞剂抗高血压治疗可改善运动能力，降低心率和血压对应激的反应，而与左心室结构变化无关。
