What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: hypertension (n=50). Intervention: Beta-blockers vs. Angiotensin II receptor blockers. Primary outcome: Systolic blood pressure at minute 6 of post-exercise recovery (p=0.0157).

What question did this study set out to answer?

This study aims to compare the post-exercise recovery hemodynamics of hypertensive patients using beta-blockers to those using angiotensin receptor blockers.

April 27, 2026Open Access

Attenuation of Cardiovascular Stress in Beta-Blocker Users Compared to Angiotensin Receptor Blocker Users: Analysis of Recovery Following Treadmill Exercise Testing: A Cross-Sectional Study

Key Result

Hypertensive patients on beta-blockers exhibited significantly lower systolic blood pressure at minute 6 of post-exercise recovery compared to those on ARBs (135 vs 143 mmHg, P=0.0157).

Key Points

This study aims to compare the post-exercise recovery hemodynamics of hypertensive patients using beta-blockers to those using angiotensin receptor blockers.
Cross-sectional study involving 50 hypertensive adults, 19 on beta-blockers and 31 on angiotensin receptor blockers.
Participants underwent treadmill exercise testing with blood pressure and heart rate measured at rest, peak exercise, and during a 6-minute recovery.
Statistical comparisons were made between groups at various time points during recovery.
Beta-blocker users had significantly lower systolic blood pressure during recovery at all measured time points, with minute 6 values of 135 ± 10 mmHg vs 143 ± 11 mmHg (P = 0.0157).
The rate–pressure product at recovery minute 6 was also lower in the beta-blocker group, measuring 12,260 ± 732 vs 14,500 ± 401 mmHg·beats/min (P = 0.0056).
Heart rate during recovery was lower in beta-blocker users at minutes 1, 2, 4, and 6, all showing P < 0.05.

Study Design

Type

Cross-Sectional (n=50)

Structured PICO

Does beta-blocker monotherapy improve hemodynamic attenuation during post-exercise recovery compared to ARB monotherapy in adults with hypertension?

Population

50 adults with hypertension (19 on beta-blocker monotherapy and 31 on ARB monotherapy)

Intervention

Beta-blocker (BB) monotherapy

Comparator

Angiotensin II receptor blocker (ARB) monotherapy

Outcome

Hemodynamic attenuation (systolic blood pressure, heart rate, and rate-pressure product) throughout a 6-minute post-exercise recovery periodsurrogate

Hypertensive patients on beta-blockers show greater attenuation of cardiovascular stress during post-exercise recovery compared to those on ARBs, which may impact the interpretation of exercise testing.

Main Result

Absolute Event Rate: 135% vs 143%

p-value: p=0.0157

Abstract

Purpose: Recovery after exercise is a critical window for assessing cardiovascular regulation and medication effects. Because beta-blockers (BB) attenuate sympathetic activity, we hypothesized that hypertensive patients using BB would demonstrate greater hemodynamic attenuation during post-exercise recovery compared with those using angiotensin II receptor blockers (ARBs). Methods: Fifty adults with hypertension (19 on BB monotherapy and 31 on ARB monotherapy) underwent treadmill exercise testing with standardized blood pressure (BP) and heart rate (HR) measurements at rest, peak exercise, and throughout a 6-minute recovery period. Results: Baseline systolic blood pressure (SBP) was similar between groups (BB: 125 ± 2 mmHg vs . ARBs: 129 ± 2 mmHg, P = 0.2879). During recovery, BB users exhibited significantly lower SBP at all time points, including minute 6 (135 ± 10 vs . 143 ± 11 mmHg, P = 0.0157), with differences evident from minute 1 onward ( P < 0.05 for all). The rate–pressure product at recovery minute 6 was also lower in the BB group (12,260 ± 732 vs . 14,500 ± 401 mmHg·beats/min, P = 0.0056). HR during recovery was consistently lower among BB users at minutes 1, 2, 4, and 6 (all P < 0.05), reflecting blunted sympathetic drive. Conclusions: Hypertensive patients treated with BB exhibit greater attenuation of cardiovascular stress during post-exercise recovery compared with those using ARBs. These findings support a medication-specific effect on recovery hemodynamics, likely mediated by sympathetic blockade, with potential implications for exercise testing interpretation and cardiovascular risk stratification.