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. 1991 Aug;32(2):201–207. doi: 10.1111/j.1365-2125.1991.tb03882.x

Effects of selective beta 2-adrenoceptor blockade on serum potassium and exercise performance in normal men.

L Gullestad 1, K Birkeland 1, G Nordby 1, S Larsen 1, J Kjekshus 1
PMCID: PMC1368444  PMID: 1681847

Abstract

1. The differential effects of beta-adrenoceptor subtypes on potassium fluxes and exercise capacity were compared in eight healthy young men using single oral doses of the selective beta 2-adrenoceptor antagonist ICI-118551, the selective beta 1-adrenoceptor antagonist atenolol or the non-selective beta-adrenoceptor antagonist propranolol. The study was randomized, double-blind and placebo controlled. 2. Potassium in the venous effluent from the exercising muscles increased progressively with increasing exercise intensity. This response was augmented by propranolol, whereas neither atenolol nor ICI-118551 modified the response. After exercise potassium concentration fell exponentially with no difference between the treatment regimens. 3. Cumulative work was significantly reduced by ICI-118551 (6.4%, P = 0.04) and by propranolol (12.4%, P less than 0.01), whereas the reduction with atenolol (5.6%) did not reach statistical significance. 4. Atenolol and propranolol reduced peak heart rate by 23% and 29%, and peak systolic blood pressure by 9% and 11% respectively during maximal exercise. ICI-118551 caused a non-significant reduction in heart rate during submaximal exercise, with a significant reduction at maximum exercise (6% reduction), whereas systolic blood pressure was not different from placebo. Diastolic blood pressures were similar across all treatment regimens. 5. Similar glucose concentrations were obtained at baseline and at exhaustion during all treatment regimens. Lactate concentrations were comparable for any given exercise intensity irrespective of treatment regimens. Propranolol reduced lactate concentrations from the exercising muscles at maximum exercise in proportion to the reduction of maximal exercise capacity. 6. The subjective perception of fatigue was not affected by either beta 1- or beta 2-adrenoceptor blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

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  1. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970;2(2):92–98. [PubMed] [Google Scholar]
  2. Brown M. J., Brown D. C., Murphy M. B. Hypokalemia from beta2-receptor stimulation by circulating epinephrine. N Engl J Med. 1983 Dec 8;309(23):1414–1419. doi: 10.1056/NEJM198312083092303. [DOI] [PubMed] [Google Scholar]
  3. Carlsson E., Fellenius E., Lundborg P., Svensson L. beta-Adrenoceptor blockers, plasma-potassium, and exercise. Lancet. 1978 Aug 19;2(8086):424–425. doi: 10.1016/s0140-6736(78)91893-7. [DOI] [PubMed] [Google Scholar]
  4. Clausen T., Flatman J. A. Beta 2-adrenoceptors mediate the stimulating effect of adrenaline on active electrogenic Na-K-transport in rat soleus muscle. Br J Pharmacol. 1980 Apr;68(4):749–755. doi: 10.1111/j.1476-5381.1980.tb10868.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. D'Silva J. L. The action of adrenaline on serum potassium. J Physiol. 1934 Nov 12;82(4):393–398. doi: 10.1113/jphysiol.1934.sp003190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ellingsen O., Sejersted O. M., Leraand S., Ilebekk A. Catecholamine-induced myocardial potassium uptake mediated by beta 1-adrenoceptors and adenylate cyclase activation in the pig. Circ Res. 1987 Apr;60(4):540–550. doi: 10.1161/01.res.60.4.540. [DOI] [PubMed] [Google Scholar]
  7. Epstein S., Robinson B. F., Kahler R. L., Braunwald E. Effects of beta-adrenergic blockade on the cardiac response to maximal and submaximal exercise in man. J Clin Invest. 1965 Nov;44(11):1745–1753. doi: 10.1172/JCI105282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Everts M. E., Retterstøl K., Clausen T. Effects of adrenaline on excitation-induced stimulation of the sodium-potassium pump in rat skeletal muscle. Acta Physiol Scand. 1988 Oct;134(2):189–198. doi: 10.1111/j.1748-1716.1988.tb08479.x. [DOI] [PubMed] [Google Scholar]
  9. Friedman D. B., Musch T. I., Williams R. S., Ordway G. A. Beta adrenergic blockade with propranolol and atenolol in the exercising dog: evidence for beta 2 adrenoceptors in the sinoatrial node. Cardiovasc Res. 1987 Feb;21(2):124–129. doi: 10.1093/cvr/21.2.124. [DOI] [PubMed] [Google Scholar]
  10. Gullestad L., Dolva L. O., Nordby G., Skaaraas K., Larsen S., Kjekshus J. The importance of potassium and lactate for maximal exercise performance during beta blockade. Scand J Clin Lab Invest. 1989 Oct;49(6):521–528. doi: 10.3109/00365518909089131. [DOI] [PubMed] [Google Scholar]
  11. Gullestad L., Dolva L. O., Søyland E., Kjekshus J. Difference between beta-1-selective and non-selective beta-blockade during continuous and intermittent exercise. Clin Physiol. 1988 Oct;8(5):487–499. doi: 10.1111/j.1475-097x.1988.tb00214.x. [DOI] [PubMed] [Google Scholar]
  12. Hirche H., Schumacher E., Hagemann H. Extracellular K+ concentration and K+ balance of the gastrocnemius muscle of the dog during exercise. Pflugers Arch. 1980 Sep;387(3):231–237. doi: 10.1007/BF00580975. [DOI] [PubMed] [Google Scholar]
  13. Hník P., Holas M., Krekule I., Kŭriz N., Mejsnar J., Smiesko V., Ujec E., Vyskocil F. Work-induced potassium changes in skeletal muscle and effluent venous blood assessed by liquid ion-exchanger microelectrodes. Pflugers Arch. 1976 Mar 11;362(1):85–94. doi: 10.1007/BF00588685. [DOI] [PubMed] [Google Scholar]
  14. Irving M. H., Britton B. J., Wood W. G., Padgham C., Carruthers M. Effects of beta adrenergic blockade on plasma catecholamines in exercise. Nature. 1974 Apr 5;248(448):531–533. doi: 10.1038/248531a0. [DOI] [PubMed] [Google Scholar]
  15. Jones D. A. Muscle fatigue due to changes beyond the neuromuscular junction. Ciba Found Symp. 1981;82:178–196. doi: 10.1002/9780470715420.ch11. [DOI] [PubMed] [Google Scholar]
  16. Juhlin-Dannfelt A. beta-Adrenoceptor blockade and exercise: effects on endurance and physical training. Acta Med Scand Suppl. 1983;672:49–54. doi: 10.1111/j.0954-6820.1983.tb01613.x. [DOI] [PubMed] [Google Scholar]
  17. Katz A., Sahlin K., Juhlin-Dannfelt A. Effect of beta-adrenoceptor blockade on H+ and K+ flux in exercising humans. J Appl Physiol (1985) 1985 Aug;59(2):336–341. doi: 10.1152/jappl.1985.59.2.336. [DOI] [PubMed] [Google Scholar]
  18. Leitch A. G., Clancy L. J., Costello J. F., Flenley D. C. Effect of intravenous infusion of salbutamol on ventilatory response to carbon dioxide and hypoxia and on heart rate and plasma potassium in normal men. Br Med J. 1976 Feb 14;1(6006):365–367. doi: 10.1136/bmj.1.6006.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Linton R. A., Lim M., Wolff C. B., Wilmshurst P., Band D. M. Arterial plasma potassium measured continuously during exercise in man. Clin Sci (Lond) 1984 Oct;67(4):427–431. doi: 10.1042/cs0670427. [DOI] [PubMed] [Google Scholar]
  20. Lundborg P., Aström H., Bengtsson C., Fellenius E., von Schenck H., Svensson L., Smith U. Effect of beta-adrenoceptor blockade on exercise performance and metabolism. Clin Sci (Lond) 1981 Sep;61(3):299–305. doi: 10.1042/cs0610299. [DOI] [PubMed] [Google Scholar]
  21. Macdonald I. A., Bennett T., Brown A. M., Wilcox R. G., Skene A. M. The effects of acute or chronic ingestion of propranolol or metoprolol on the metabolic and hormonal responses to prolonged, submaximal exercise in hypertensive men. Br J Clin Pharmacol. 1984 Mar;17(3):283–293. doi: 10.1111/j.1365-2125.1984.tb02343.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. McGibney D., Singleton W., Silke B., Taylor S. H. Observations on the mechanism underlying the differences in exercise and isoprenaline tachycardia after cardioselective and non-selective beta-adrenoceptor antagonists. Br J Clin Pharmacol. 1983 Jan;15(1):15–19. doi: 10.1111/j.1365-2125.1983.tb01457.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. McSorley P. D., Warren D. J. Effects of propranolol and metoprolol on the peripheral circulation. Br Med J. 1978 Dec 9;2(6152):1598–1600. doi: 10.1136/bmj.2.6152.1598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Medbø J. I., Sejersted O. M. Plasma potassium changes with high intensity exercise. J Physiol. 1990 Feb;421:105–122. doi: 10.1113/jphysiol.1990.sp017935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pearson S. B., Banks D. C., Patrick J. M. The effect of beta-adrenoceptor blockade on factors affecting exercise tolerance in normal man. Br J Clin Pharmacol. 1979 Aug;8(2):143–148. doi: 10.1111/j.1365-2125.1979.tb05812.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Pringle T. H., Riddell J. G., Shanks R. G. Characterization of the beta-adrenoreceptors which mediate the isoprenaline-induced changes in finger tremor and cardiovascular function in man. Eur J Clin Pharmacol. 1988;35(5):507–514. doi: 10.1007/BF00558246. [DOI] [PubMed] [Google Scholar]
  27. Rolett E. L., Strange S., Sjøgaard G., Kiens B., Saltin B. Beta 2-adrenergic stimulation does not prevent potassium loss from exercising quadriceps muscle. Am J Physiol. 1990 May;258(5 Pt 2):R1192–R1200. doi: 10.1152/ajpregu.1990.258.5.R1192. [DOI] [PubMed] [Google Scholar]
  28. Rolf Smith S., Kendall M. J., Worthington D. J., Holder R. Can the biochemical responses to a beta 2-adrenoceptor stimulant be used to assess the selectivity of beta-adrenoceptor blockers? Br J Clin Pharmacol. 1983 Nov;16(5):557–560. doi: 10.1111/j.1365-2125.1983.tb02216.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Sklar J., Johnston G. D., Overlie P., Gerber J. G., Brammell H. L., Gal J., Nies A. S. The effects of a cardioselective (metoprolol) and a nonselective (propranolol) beta-adrenergic blocker on the response to dynamic exercise in normal men. Circulation. 1982 May;65(5):894–899. doi: 10.1161/01.cir.65.5.894. [DOI] [PubMed] [Google Scholar]
  30. Stiles G. L., Taylor S., Lefkowitz R. J. Human cardiac beta-adrenergic receptors: subtype heterogeneity delineated by direct radioligand binding. Life Sci. 1983 Aug 1;33(5):467–473. doi: 10.1016/0024-3205(83)90796-8. [DOI] [PubMed] [Google Scholar]
  31. Struthers A. D., Reid J. L., Whitesmith R., Rodger J. C. The effects of cardioselective and non-selective beta-adrenoceptor blockade on the hypokalaemic and cardiovascular responses to adrenomedullary hormones in man. Clin Sci (Lond) 1983 Aug;65(2):143–147. doi: 10.1042/cs0650143. [DOI] [PubMed] [Google Scholar]
  32. Todd E. P., Vick R. L. Kalemotropic effect of epinephrine: analysis with adrenergic agonists and antagonists. Am J Physiol. 1971 Jun;220(6):1964–1969. doi: 10.1152/ajplegacy.1971.220.6.1964. [DOI] [PubMed] [Google Scholar]
  33. Vanhees L., Aubert A., Fagard R., Hespel P., Amery A. Influence of beta 1- versus beta 2-adrenoceptor blockade on left ventricular function in humans. J Cardiovasc Pharmacol. 1986 Sep-Oct;8(5):1086–1091. doi: 10.1097/00005344-198609000-00030. [DOI] [PubMed] [Google Scholar]
  34. Vick R. L., Todd E. P., Luedke D. W. Epinephrine-induced hypokalemia: relation to liver and skeletal muscle. J Pharmacol Exp Ther. 1972 Apr;181(1):139–146. [PubMed] [Google Scholar]
  35. Vøllestad N. K., Sejersted O. M. Biochemical correlates of fatigue. A brief review. Eur J Appl Physiol Occup Physiol. 1988;57(3):336–347. doi: 10.1007/BF00635993. [DOI] [PubMed] [Google Scholar]
  36. Williams M. E., Gervino E. V., Rosa R. M., Landsberg L., Young J. B., Silva P., Epstein F. H. Catecholamine modulation of rapid potassium shifts during exercise. N Engl J Med. 1985 Mar 28;312(13):823–827. doi: 10.1056/NEJM198503283121304. [DOI] [PubMed] [Google Scholar]
  37. Williams M. E., Rosa R. M., Silva P., Brown R. S., Epstein F. H. Impairment of extrarenal potassium disposal by alpha-adrenergic stimulation. N Engl J Med. 1984 Jul 19;311(3):145–149. doi: 10.1056/NEJM198407193110303. [DOI] [PubMed] [Google Scholar]

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