The Funcional Effect of Beta Blockers vs Vasodilators in Hypertension Treatment

Journal of Clinical and Basic Cardiology 2008; 11 (1-4): 8-10

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Keywords: beta blocker,  cardiopulmonary exercise test,  hypertension treatment,  vasodilator

Objective: To evaluate and compare retrospectively the physiological effect of beta blockers versus vasodilators in the treatment of hypertensive patients (pts). Methods: 42 diagnosed hypertensive pts (24 male, 18 female) were studied. They were divided into two groups: (1) 16 patients treated with vasodilators only and (2) 26 patients treated only with beta blockers. A cardiopulmonary exercise test (CPET) was performed in all pts while they were taking their medications as usual. The following indices were monitored and measured breath by breath during exercise: heart rate (HR), blood pressure (BP), oxygen consumption (VO2), oxygen pulse (O2P), ventilatory anaerobic threshold (VAT) and respiratory exchange ratio (RER). Maximal exercise capacity was considered as RER having reached a value of at least 1.15. Peak values of the CPET indices were compared between the two groups for each index separately by the two-tailed Student T test. P values < 0.05 were considered statistically significant. Results: No significant differences were observed between groups A and B, respectively, as follows: age 58 ± 13 vs 59 ± 10; RER 1.17 ± 0.12 vs 1.17 ± 0.1; and peak O2P 108 ± 13 vs 102 ± 33. Significant differences between the two groups were observed in: peak HR (% of predicted HR) 90 ± 8 vs 69 ± 12; peak VO2 (% of predicted VO2) 96 ± 9 vs 69 ± 11; and VAT (% of max VO2 predicted) 55 ± 8 vs 43 ± 9 (p < 0.05). Conclusions: Beta blockers in the treatment of hypertensive patients demonstrate a significant physiological disadvantage compared to vasodilator treatment. These findings further validate the CPET as an important tool for physiological evaluation of various treatments in hypertensive patients.