Is Exercise Training Beneficial for Heart Failure Patients Taking β‐Adrenergic Blockers? A Systematic Review and Meta‐Analysis

Abstract

The authors sought to conduct a systematic review comparing the effects of exercise training in heart failure patients taking β-blockers vs those not. A systematic search of exercise training trials in chronic heart failure patients that compared groups who took β-blocker medication or compared selective and nonselective β-blockers during exercise training was conducted. Eight prospective studies met the criteria for the quantitative synthesis, which included data from 236 participants. The increment in peak oxygen consumption (VO(2)) was greater in exercising vs control participants, with a mean difference (MD) of 1.27 mL/kg/min (95% confidence interval [CI], 0.85-1.70; P<.00001). In exercising patients, the increment in peak VO(2) was greater in the group taking β-blocker vs those taking placebo (MD, 1.66 mL/kg/min; 95% CI, 0.36-2.97; P=.01). In exercising patients, there was no difference in the increment of peak VO(2) between nonselective β-blocker and selective β-blockers groups (MD, -0.09 mL/kg/min; 95% CI, -1.54-1.36; P=.09). Minnesota Quality of Life Score was significantly better in the exercise group vs sedentary control group (both groups taking β-blockers) (MD, -11.3; 95% CI, -15.9 to -6.8; P<.00001). Our analysis demonstrated that β-adrenergic blocker therapy did not reduce exercise capacity or exercise training adaptations and quality of life in heart failure patients.

Validation of a new tool for the assessment of study quality and reporting in exercise training studies

“…7 The authors of this work have experience assessing study quality for numerous published metaanalyses. [8][9][10][11][12][13][14][15] The PEDro scale is perhaps the tool that comes closest to meeting the methodological and reporting requirements of exercise studies; however, several shortcomings remain.…”

Effect of cardiac rehabilitation on cardiovascular risk factors in chronic heart failure patients

“… 26 A systematic review of eight prospective studies, found that MLHFQ Score was significantly better in the exercise group vs. sedentary control group in heart failure patients. 27 …”

The Effects of Medication on Activity and Rehabilitation of Older People – Opportunities and Risks

“…For some patients, β-blockers can worsen symptoms of tiredness; available data on the impact of β-blockers on exercise training programmes for heart failure is reassuring, however, in that β-blockers do not appear to impair the benefit of exercise training on exercise capacity. 18…”