title: Differential effects of beta-adrenoreceptor antagonists on central and peripheral blood pressure at rest and during exercise.
abstract: BACKGROUND
  Differential effects of beta-adrenoreceptor antagonists (beta-ARB) on central and peripheral blood pressure may relate to change in heart rate and/or vasodilator tone and thus be exaggerated during exercise.
  
  
  OBJECTIVE
  To examine acute effects of selective and nonselective beta-ARB on central and peripheral blood pressure, cardiac output and peripheral vascular resistance during exercise.
  
  
  METHODS
  Healthy volunteers (n= 20, 18 men, 19-54 years) received propranolol 80 mg, bisoprolol 20 mg, and placebo 1 h before bicycle ergometry (50, 75 and 100 W each for 3 min) in a randomized, cross-over study. Cardiac output was determined by pulmonary uptake of soluble and inert gas tracers (InnoCor, Innovision). Central systolic blood pressure (SBP) was determined from the late systolic shoulder of the digital artery pressure waveform (Finometer, Finopres).
  
  
  RESULTS
  At rest, both beta-ARB reduced brachial but not central SBP (compared with placebo). During exercise, beta-ARB reduced brachial SBP (reductions of 19.9 +/- 4.3 mmHg and 23.2 +/- 2.7 mmHg for propranolol and bisoprolol, respectively, at 100 W, each P < 0.0001) but not central SBP. The difference between peripheral and central SBP was reduced, relative to that during placebo, by 21.5 mmHg (95% confidence interval 8.8, 34.1) and 26.4 mmHg (18.1, 34.8) for propranolol and bisoprolol, respectively, at 100 W (each P < 0.01). There was no significant effect of beta-ARB on diastolic blood pressure or peripheral vascular resistance.
  
  
  CONCLUSIONS
  Despite reducing brachial blood pressure, acute beta-adrenoreceptor blockade in man at rest and during exercise does not reduce central blood pressure.
authors.affiliation: King's College London School of Medicine, Department of Clinical Pharmacology, St Thomas' Hospital, London, UK.
authors.forename: James A
authors.initials: JA
authors.lastname: Cockburn
authors.forename: Sally E
authors.initials: SE
authors.lastname: Brett
authors.forename: Antoine
authors.initials: A
authors.lastname: Guilcher
authors.forename: Albert
authors.initials: A
authors.lastname: Ferro
authors.forename: James M
authors.initials: JM
authors.lastname: Ritter
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Chowienczyk
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology*; D017298:Bisoprolol / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000187:drug effects; D018592:Cross-Over Studies; D003971:Diastole; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000494:pharmacology*; D013599:Systole; D014655:Vascular Resistance / Q000187:drug effects; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D011433:Propranolol; D017298:Bisoprolol
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