Effectiveness of β-blockers in physically active patients with hypertension: protocol of a systematic review

INTRODUCTION: Based on more than 5 decades of epidemiological studies, it is now widely accepted that higher physical activity patterns and levels of cardiorespiratory fitness are associated with better health outcomes. Therefore, it is necessary to consider how treatment methods affect these two components. Clinically, one very important question concerns the influence of aerobic performance on patients being treated for hypertension. The administration of β-blockers can significantly reduce maximal—and especially submaximal—aerobic exercise capacity. The objective of this review is to determine, by comparison of existing mono and combination therapy, which β-blockers are less physically limiting for patients with hypertension who are physically active. METHODS: A three-step strategy will be adopted in the review, following the methods used by the Joanna Briggs Institute (JBI). The initial search will be conducted using the MEDLINE and EMBASE databases. The second search will involve the listed databases for the published literature (MEDLINE, Biomedica Czechoslovaca, Tripdatabase, Pedro, EMBASE, the Cochrane Central Register of Controlled Trials, Cinahl, WoS) and the unpublished literature (Open Grey, Current Controlled Trials, MedNar, ClinicalTrials.gov, Cos Conference Papers Index, the International Clinical Trials Registry Platform of the WHO). Following the JBI methodology, analysis of title/abstracts and full texts, critical appraisal and data extraction will be carried out on selected studies using the JBI tool, MAStARI. This will be performed by two independent reviewers. If possible, statistical meta-analysis will be pooled. Statistical heterogeneity will be assessed. Subgroup analysis will be used for different age and gender characteristics. Funnel plots, Begg's rank correlation and Egger's regression test will be used to detect or correct publication bias. ETHICS AND DISSEMINATION: The results will be disseminated by publishing in a peer-reviewed journal. Ethical assessment is not needed—we will search/evaluate the existing sources of literature. TRIAL REGISTRATION NUMBER: CRD42015026914.