Abstract
Forty men with chronic stable angina and no prior myocardial infarction were studied. Exercise tolerance testing was carried out off treatment and after beta blockade. beta Blockers were stopped and the patients were randomised to a control group and a study group of patients who undertook a one year high intensity training programme. The groups were then restudied. Submaximum heart rate was reduced by 13 beats per minute by training and by 23 beats per minute by atenolol. Training increased the maximum heart rate by 10 beats per minute and atenolol reduced it by 29 beats per minute. The double produce ST threshold was increased from 183 to 205 by training but reduced to 143 by atenolol. Maximum ST depression was similarly reduced by both training and atenolol. As a result of the effects on maximum heart rate, training produced a greater improvement in exercise tolerance than atenolol with a treadmill time increased from 741 seconds to 1272 seconds with training compared with 974 seconds with atenolol. Other variables were similarly affected. Thus the antianginal efficacy of exercise training is as good as that achieved by beta blockade and represents an alternative to such treatment.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Clausen J. P., Larsen O. A., Trap-Jensen J. Physical training in the management of coronary artery disease. Circulation. 1969 Aug;40(2):143–154. doi: 10.1161/01.cir.40.2.143. [DOI] [PubMed] [Google Scholar]
- Clausen J. P., Trap-Jensen J. Heart rate and arterial blood pressure during exercise in patients with angina pectoris. Effects of training and of nitroglycerin. Circulation. 1976 Mar;53(3):436–442. doi: 10.1161/01.cir.53.3.436. [DOI] [PubMed] [Google Scholar]
- Dagenais G. R., Pitt B., Ross R. S. Exercise tolerance in patients with angina pectoris. Daily variation and effects of erythrityl tetranitrate, propranolol and alprenolol. Am J Cardiol. 1971 Jul;28(1):10–16. doi: 10.1016/0002-9149(71)90028-2. [DOI] [PubMed] [Google Scholar]
- DeBusk R. F. Physical conditioning following myocardial infarction. Adv Cardiol. 1982;31:156–161. doi: 10.1159/000407138. [DOI] [PubMed] [Google Scholar]
- Dressendorfer R. H., Smith J. L., Amsterdam E. A., Mason D. T. Reduction of submaximal exercise myocardial oxygen demand post-walk training program in coronary patients due to improved physical work efficiency. Am Heart J. 1982 Mar;103(3):358–362. doi: 10.1016/0002-8703(82)90274-5. [DOI] [PubMed] [Google Scholar]
- Ehsani A. A. Altered adaptive responses to training by nonselective beta-adrenergic blockade in coronary artery disease. Am J Cardiol. 1986 Aug 1;58(3):220–224. doi: 10.1016/0002-9149(86)90050-0. [DOI] [PubMed] [Google Scholar]
- Ehsani A. A., Biello D. R., Schultz J., Sobel B. E., Holloszy J. O. Improvement of left ventricular contractile function by exercise training in patients with coronary artery disease. Circulation. 1986 Aug;74(2):350–358. doi: 10.1161/01.cir.74.2.350. [DOI] [PubMed] [Google Scholar]
- Ehsani A. A., Heath G. W., Hagberg J. M., Sobel B. E., Holloszy J. O. Effects of 12 months of intense exercise training on ischemic ST-segment depression in patients with coronary artery disease. Circulation. 1981 Dec;64(6):1116–1124. doi: 10.1161/01.cir.64.6.1116. [DOI] [PubMed] [Google Scholar]
- Froelicher V., Jensen D., Sullivan M. A randomized trial of the effects of exercise training after coronary artery bypass surgery. Arch Intern Med. 1985 Apr;145(4):689–692. [PubMed] [Google Scholar]
- Goldbarg A. N., Moran J. F., Butterfield T. K., Nemickas R., Bermudez G. A. Therapy of angina pectoris with propranolol and long-acting nitrates. Circulation. 1969 Dec;40(6):847–853. [PubMed] [Google Scholar]
- Jackson G., Schwartz J., Kates R. E., Winchester M., Harrison D. C. Atenolol: once-daily cardioselective beta blockade for angina pectoris. Circulation. 1980 Mar;61(3):555–560. doi: 10.1161/01.cir.61.3.555. [DOI] [PubMed] [Google Scholar]
- Jensen D., Atwood J. E., Froelicher V., McKirnan M. D., Battler A., Ashburn W., Ross J., Jr Improvement in ventricular function during exercise studied with radionuclide ventriculography after cardiac rehabilitation. Am J Cardiol. 1980 Nov;46(5):770–777. doi: 10.1016/0002-9149(80)90427-0. [DOI] [PubMed] [Google Scholar]
- Laslett L. J., Paumer L., Scott-Baier P., Amsterdam E. A. Efficacy of exercise training in patients with coronary artery disease who are taking propranolol. Circulation. 1983 Nov;68(5):1029–1034. doi: 10.1161/01.cir.68.5.1029. [DOI] [PubMed] [Google Scholar]
- Murray G. C., Beller G. A. Cardiac rehabilitation following coronary artery bypass surgery. Am Heart J. 1983 Jun;105(6):1009–1018. doi: 10.1016/0002-8703(83)90404-0. [DOI] [PubMed] [Google Scholar]
- Oldridge N. B., Nagle F. J., Balke B., Corliss R. J., Kahn D. R. Aortocoronary bypass surgery: effects of surgery and 32 months of physical conditioning on treadmill performance. Arch Phys Med Rehabil. 1978 Jun;59(6):268–275. [PubMed] [Google Scholar]
- Patterson J. A., Naughton J., Pietras R. J., Gunnar R. M. Treadmill exercise in assessment of the functional capacity of patients with cardiac disease. Am J Cardiol. 1972 Nov;30(7):757–762. doi: 10.1016/0002-9149(72)90151-8. [DOI] [PubMed] [Google Scholar]
- Pratt C. M., Welton D. E., Squires W. G., Jr, Kirby T. E., Hartung G. M., Miller R. R. Demonstration of training effect during chronic beta-adrenergic blockade in patients with coronary artery disease. Circulation. 1981 Dec;64(6):1125–1129. doi: 10.1161/01.cir.64.6.1125. [DOI] [PubMed] [Google Scholar]
- Raffo J. A., Luksic I. Y., Kappagoda C. T., Mary D. A., Whitaker W., Linden R. J. Effects of physical training on myocardial ischaemia in patients with coronary artery disease. Br Heart J. 1980 Mar;43(3):262–269. doi: 10.1136/hrt.43.3.262. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Redwood D. R., Rosing D. R., Epstein S. E. Circulatory and symptomatic effects of physical training in patients with coronary-artery disease and angina pectoris. N Engl J Med. 1972 May 4;286(18):959–965. doi: 10.1056/NEJM197205042861801. [DOI] [PubMed] [Google Scholar]
- Schuler G., Schlierf G., Wirth A., Mautner H. P., Scheurlen H., Thumm M., Roth H., Schwarz F., Kohlmeier M., Mehmel H. C. Low-fat diet and regular, supervised physical exercise in patients with symptomatic coronary artery disease: reduction of stress-induced myocardial ischemia. Circulation. 1988 Jan;77(1):172–181. doi: 10.1161/01.cir.77.1.172. [DOI] [PubMed] [Google Scholar]
- Sim D. N., Neill W. A. Investigation of the physiological basis for increased exercise threshold for angina pectoris after physical conditioning. J Clin Invest. 1974 Sep;54(3):763–770. doi: 10.1172/JCI107814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Todd I. C., McGuinness J. B., Ballantyne D. Abolition of exercise induced ST depression after exercise training and its recurrence after beta blockade. Br Heart J. 1988 Feb;59(2):259–262. doi: 10.1136/hrt.59.2.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tubau J., Witztum K., Froelicher V., Jensen D., Atwood E., McKirnan M. D., Reynolds J., Ashburn W. Noninvasive assessment of changes in myocardial perfusion and ventricular performance following exercise training. Am Heart J. 1982 Aug;104(2 Pt 1):238–248. doi: 10.1016/0002-8703(82)90199-5. [DOI] [PubMed] [Google Scholar]
- Vanhees L., Fagard R., Amery A. Influence of beta-adrenergic blockade on the hemodynamic effects of physical training in patients with ischemic heart disease. Am Heart J. 1984 Aug;108(2):270–275. doi: 10.1016/0002-8703(84)90611-2. [DOI] [PubMed] [Google Scholar]
- Winder W. W., Hagberg J. M., Hickson R. C., Ehsani A. A., McLane J. A. Time course of sympathoadrenal adaptation to endurance exercise training in man. J Appl Physiol Respir Environ Exerc Physiol. 1978 Sep;45(3):370–374. doi: 10.1152/jappl.1978.45.3.370. [DOI] [PubMed] [Google Scholar]
- Winter C., Kardash M. M., Whitaker W., Mary D. A., Linden R. J. The effects of long-term physical training in patients with coronary heart disease. Int J Cardiol. 1984 Jun;5(6):675–688. doi: 10.1016/0167-5273(84)90214-6. [DOI] [PubMed] [Google Scholar]
