Key result
Beta-blocker treatment was associated with higher odds of a non-regular heart rate performance curve compared to healthy controls, with the odds decreasing with older age (OR 0.97; 95% CI 0.94-0.99).
Why the study?
Heart rate performance curves (HRPC) vary due to beta-adrenergic sensitivity, but age- and sex-dependent differences between individuals on beta-blocker treatment and healthy controls remained unclear.
Does beta-blocker treatment alter the heart rate performance curve pattern during incremental exercise compared to healthy controls?
Case-Control (n=1,070)
Does beta-blocker treatment alter the heart rate performance curve pattern during incremental exercise compared to healthy controls?
Answers are grounded in this paper and cite their sources.
Beta-blocker treatment alters the heart rate performance curve during incremental exercise, suggesting that percentage of maximal power output (%Pmax) is a more stable indicator for exercise intensity prescription than percentage of maximal heart rate (%HRmax).
(1): Heart rate performance curve (HRPC) in incremental exercise was shown to be not uniform, causing false intensity estimation applying percentages of maximal heart rate (HRmax). HRPC variations are mediated by β-adrenergic receptor sensitivity. The aim was to study age and sex dependent differences in HRPC patterns in adults with β-blocker treatment (BB) and healthy controls (C). (2): A total of 535 (102 female) BB individuals were matched 1:1 for age and sex (male 59 ± 11 yrs, female 61 ± 11 yrs) in C. From the maximum incremental cycle ergometer exercise a first and second heart rate (HR) threshold (Th1 and Th2) was determined. Based on the degree of the deflection (kHR), HRPCs were categorized as regular (downward deflection (kHR > 0.1)) and non-regular (upward deflection (kHR < 0.1), linear time course). (3): Logistic regression analysis revealed a higher odds ratio to present a non-regular curve in BB compared to C (females showed three times higher odds). The odds for non-regular HRPC in BB versus C decreased with older age (OR interaction = 0.97, CI = 0.94–0.99). Maximal and submaximal performance and HR variables were significantly lower in BB (p < 0.05). %HRmax was significantly lower in BB versus C at Th2 (male: 77.2 ± 7.3% vs. 80.8 ± 5.0%; female: 79.2 ± 5.1% vs. 84.0 ± 4.3%). %Pmax at Th2 was similar in BB and C. (4): The HRPC pattern in incremental cycle ergometer exercise is different in individuals receiving β-blocker treatment compared to healthy individuals. The effects were also dependent on age and sex. Relative HR values at Th2 varied substantially depending on treatment. Thus, the percentage of Pmax seems to be a stable and independent indicator for exercise intensity prescription.
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Birnbaumer et al. (2021) conducted a case-control in Beta-blocker treatment (n=1,070). Beta-blocker treatment vs. Healthy controls was evaluated on Non-regular heart rate performance curve (HRPC) pattern (OR 0.97, 95% CI 0.94-0.99). Beta-blocker treatment was associated with higher odds of a non-regular heart rate performance curve compared to healthy controls, with the odds decreasing with older age (OR 0.97; 95% CI 0.94-0.99).
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