Can beta-blockers influence regular daily physical activity?

Background: In hypertension, beta-blockers have a high rate of nonadherence to treatment likely because of fatigue. Methods: We evaluate daily physical activity and maximal exercise performance in 56 patients with hypertension (grades I-II), with and without beta-blockers (bisoprolol 10 mg or atenolol 100 mg) added to standard treatment; 48 patients completed the study. Study tests were performed after 8 weeks of antihypertensive therapy without beta blockers and after the following 8 weeks with beta-blockers. Results: No significant differences between beta-blockers were observed. At office measurement, beta-blockers decreased heart rate (HR) from 78 +/- 9 to 62 +/- 7 bpm (P < 0.01) and SBP from 133 +/- 13 to 125 +/- 12 mmHg (P < 0.01). No significant changes were observed for DBP. Conversely, at ambulatory pressure monitoring DBP but not SBP decreased with beta-blockers (mean-24-h DBP 77 +/- 8 vs. 74 +/- 7 mmHg, P < 0.01). An overall reduction of daily activities and of estimated kilocalories consumption was observed as measured by a portable armband device. Of note, time with activity more than 3 METS was reduced by beta-blockers from 148.1 (83-201) to 117.9 (82-189) min (P < 0.01). Cardiopulmonary exercise (CPE) showed a preserved exercise performance unaffected by beta-blockers. Conclusion: In hypertension, beta-blocker treatment is associated to reduction of daily physical activity but not of maximal exercise performance.