Comparison of continuous and intermittent multistage maximal exercise testing during beta-adrenoceptor blockade in physically active men.

Cardiorespiratory responses of 11 healthy males were studied, with placebo and propranolol, during a continuous and an intermittent multistage maximal treadmill test. With placebo, equivalent maximal heart rates were attained for the disparate test modes, and the intermittent protocol yielded a slightly higher (2%, P less than 0.01) maximal O2 consumption. In contrast, during beta-adrenoceptor blockade, higher maximal heart rates (5.1%, P less than 0.01) and O2 consumptions (4.4%, P less than 0.02) were reached with intermittent compared with continuous testing. Values were, however, markedly lower (P less than 0.001) for both protocols than with placebo. These results demonstrate that the precise degree of attenuation of maximal heart rate and O2 consumption observed in physically active persons receiving propranolol is partly dependent upon the actual test protocol utilized. Furthermore, the present data suggest an advantage for intermittent testing when accurate evaluation of the maximal cardiorespiratory capacity is desired in such individuals.

Effect of acute calcium slow-channel antagonism on the cardiorespiratory response to graded exercise testing.

The effect of acute calcium slow-channel antagonism on the cardiorespiratory responses of 12 healthy males was studied during multistage maximal exercise testing. Oral diltiazem (60 mg), nifedipine (10 mg), verapamil (80 mg), and placebo were administered in a randomized double-blind crossover fashion 1.5 h before an intermittent multistage cycle ergometer exercise test. At peak effort, heart rate, pulmonary ventilation, CO2 production, and respiratory exchange ratio were not significantly modified by drug ingestion. In contrast, maximal O2 consumption (2.6% reduction, P less than 0.02) and performance time (6.4% reduction, P less than 0.02) were reduced by nifedipine. During submaximal exercise, the chronotropic response was accentuated by nifedipine but not by diltiazem or verapamil. Furthermore, nifedipine altered the relationship of percentage of maximal O2 consumption to percentage of maximal heart rate, and both the relative and absolute O2 consumption corresponding to 70% and 85% of the maximal heart rate were significantly reduced after nifedipine ingestion. The results indicated that in persons without symptomatic coronary artery disease exercise performed at a given percentage of the maximal heart rate will yield a lower than expected relative and absolute intensity in the presence of acute nifedipine-induced calcium slow-channel antagonism.

Effect of beta1 selective adrenoceptor blockade on physiological response to exercise.

The effect of the beta1 selective adrenoceptor blocker, atenolol, on the physiological response to exercise was studied in 12 healthy young men. Oral atenolol (100 mg) and placebo were administered in a randomised double blind crossover fashion an hour and a half before an intermittent multistage cycle ergometer exercise test. At maximal effort oxygen consumption, pulmonary ventilation, carbon dioxide output, and respiratory exchange ratio were not modified by atenolol. In contrast, maximal heart rate and performance time were significantly reduced after atenolol. Nevertheless, because the relation of percentage of maximal oxygen consumption to percentage of maximal heart rate was not changed by atenolol both the absolute and relative oxygen consumption corresponding to 70% and 85% of the maximal heart rate remained unaltered. These data suggest that recommendations of exercise intensity may be determined on the basis of a calculated percentage of the predetermined maximal heart rate in persons without symptomatic coronary heart disease receiving beta1 selective adrenoceptor blockers.