Effects of beta-blockade and exercise on cardiovascular and cognitive functioning.

Abstract

SUMMARY Twenty-four men with mild essential hypertension were assigned randomly to receive propranolol (n = 9), atenolol (n = 7), or a placebo (n = 8). All subjects participated in a 12-week study and provided physiological and behavioral data four times during the study: after a medication-free baseline period (Session 1); after 2 weeks of medication, without exercise (Session 2); after 8 weeks of continued medication while participating in a program of aerobic exercise (Session 3); and after 2 weeks of maintenance exercise without medication (Session 4). Subjects 9 maximal oxygen uptake increased significantly between Sessions 2 and 3, and the magnitude of this increase did not vary across the drug groups. Subjects' resting heart rates varied as a function of the presence of ^-blocking medication, but there was in addition a reduction attributable to exercise training that did not vary across the drug groups. The decrease in blood pressure associated with 0-blockade (Session 2) was not decreased any further by exercise training (Session 3). Despite an increase in blood pressure following the withdrawal of active medication (Session 4), blood pressure remained significantly lower compared with the Session 1 baseline level. Performance in a reaction-time test of short-term memory functioning improved slightly for all three groups between Sessions 1 and 2 and remained constant thereafter. The present findings demonstrate that hypertensive persons can achieve cardiorespiratory training effects despite the presence of 0-blockade, that the combined effects of aerobic exercise training and ^-blockade do not influence performance on this test of memory functioning, and that aerobic exercise may be a useful complement to pharmacological methods for maintaining reductions in blood pressure. (Hypertension 11: 470-476, 1988) KEY WORDS • hypertension • 0-blockade • aerobic exercise • cognitive processes H YPERTENSION is a major cardiovascular disease affecting 25% of the adult population in the United States. 1 The physical consequences of hypertension include end-organ damage that can lead to kidney failure, stroke, and coronary heart disease.2 Hypertension may have behavioral consequences as well.3 In particular, hypertension-related deficits have been observed both on psychometric

Antihypertensive classes, cognitive decline and incidence of dementia

“…These trials included a total of 18 515 individuals with a mean age of 64 AE 13 years (Table 1), and follow-up of 1-54 months (median 6 months, IQR 21). All trials were randomized and double-blind except for one single-blind study [8], with data analysed on an intention-to-treat basis in 12 trials [3,5,7,[15][16][17][18][19][20][21][22][23]. No publication bias was observed by graphical analysis using the funnel plot (data not shown).…”

Assessment of cognitive function in patients with essential hypertension treated with lercanidipine

“…No changes in cognitive function seem to take place with this type of therapy, although some worsening has been reported with propranolol and slight improvements were seen with beta 1-selective blocking agents. However, it is generally accepted that these drugs do not have a positive effect on cognitive function ( Madden et al 1986 , 1988 ; Steufert et al 1988 ; Palac et al 1990 ; Steiner et al 1990 ). ACE inhibitors have been evaluated in 9 studies including a population of somewhat over 9000 hypertensive patients.…”

Antihypertensive Therapies and Cognitive Function: a Review

“…A small clinical study by Madden et al showed a slight improvement in short-term memory with βB (propranolol, atenolol), which was not different from placebo [64]. The cognitive sub-study of the MRC trial of HTN in older adults showed no influence of βB on cognitive function compared to placebo when used as a treatment of moderate HTN [33].…”