Exercise prescription for individuals using beta-blockers: a literature review

Abstract

Exercise prescription for individuals using beta-blockers requires careful consideration of intensity, duration, and heart rate (HR). The present study aimed to identify formulas for calculating maximum heart rate (HRmax ) and formulas used for adequate prescription of exercise intensity in patients on beta-blocker therapy. A literature review was conducted using the databases PubMed, PEDro, and SciELO, with the keywords “betablocker”, “exercises”, “heart rate”, “rehabilitation”, and “prediction equation”, combined using the Boolean operator “AND”. Inclusion criteria comprised: clinical trials, meta-analyses, and randomized controlled trials published in English or Portuguese, containing formulas for calculating HRmax and training HR for beta-blocked individuals. The search yielded 2,458 results, of which 4 articles were included. Two articles addressed HRmax formulas, one of which proposed formulas for patients with heart failure. The remaining two articles addressed training HR in beta-blocked individuals. The identified HRmax formula was 164 − (0.7 × age), and for specific situations involving stable patients with heart failure with reduced ejection fraction, the Keteyian formula (114 + 0.5 × HRrest − 0.5 × age) and a new equation: HRmax = 109 + (0.5 × HRrest ) − (0.5 × age) + (0.2 × LVEF) − 5 (if Hb < 11 g/dL) were identified. For exercise prescription, the Karvonen HR formula [0.6 × (HRmax − HRrest) + HRrest] or 80% of HRmax were found. For patients following acute myocardial infarction, the modified Karvonen formula was identified: HR = 0.8 × (HRmax − HRrest) + HRrest.