BETA-BLOCKERS IN SPORT: PHYSIOLOGICAL EFFECTS, PERFORMANCE IMPLICATIONS AND REGULATORY PERSPECTIVES

Keywords: Beta-Blockers, Sport Performance, Doping, Precision Sports, WADA

Abstract

Introduction: Beta-blockers are a pharmacological class widely used in cardiovascular and anxiety-related conditions. Their ability to reduce heart rate, reduce physiological tremor and attenuate sympathetic arousal has led to increasing interest regarding their use in sport. While beta-blockers impair endurance performance, they may enhance precision and emotional stability in sports requiring fine motor control. This has resulted in selective regulation by anti-doping authorities.

Aim of the study: The aim of this article was to review the current evidence on physiological effects of beta-blockers in athletes and to evaluate their sport-specific implications, including their relevance to anti-doping regulations.

Methods and Materials: Literature was reviewed using PubMed, Scopus and Google Scholar databases, focusing primarily on experimental human studies, controlled trials and mechanistic analyses investigating beta-blocker pharmacology and athletic performance. Key search terms included: “beta-blockers”, “sport performance”, “precision sports”, “beta receptors”, and “doping”.

Conclusion: Evidence indicates that beta-blockers exert mixed performance effects depending on sport characteristics. They consistently reduce endurance capacity by limiting cardiac output and metabolic efficiency, yet can benefit athletes in precision disciplines through tremor suppression and decreased somatic anxiety. These sport-specific effects justify the selective prohibition adopted by the World Anti-Doping Agency. Further research is needed to clarify individual variability in response and to refine regulatory approaches.

References

Taddei, S., Tsabedze, N., & Tan, R. S. (2024). β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications. Current medical research and opinion, 40(sup1), 15–23. https://doi.org/10.1080/03007995.2024.2318058

World Anti-Doping Agency. (2018). Therapeutic Use Exemptions: Cardiovascular Conditions – version 2.0 (January 2018). Montreal, Canada. https://www.wada-ama.org/sites/default/files/2022-01/cardiovascular_conditions_v_2.0_jan2018_en.pdf

Davis, E., Loiacono, R., & Summers, R. J. (2008). The rush to adrenaline: drugs in sport acting on the beta-adrenergic system. British journal of pharmacology, 154(3), 584–597. https://doi.org/10.1038/bjp.2008.164

Ergen, E., Hazir, T., Celebi, M., Kin-Isler, A., Aritan, S., Yaylıoglu, V. D., Guner, R., Acikada, C., & Cinemre, A. (2021). Effects of beta-blockers on archery performance, body sway and aiming behaviour. BMJ open sport & exercise medicine, 7(2), e001071. https://doi.org/10.1136/bmjsem-2021-001071

Kruse, P., Ladefoged, J., Nielsen, U., Paulev, P. E., & Sørensen, J. P. (1986). beta-Blockade used in precision sports: effect on pistol shooting performance. Journal of applied physiology (Bethesda, Md. : 1985), 61(2), 417–420. https://doi.org/10.1152/jappl.1986.61.2.417

Gordon, N. F., & Duncan, J. J. (1991). Effect of beta-blockers on exercise physiology: implications for exercise training. Medicine and science in sports and exercise, 23(6), 668–676.

Cleroux, J., Van Nguyen, P., Taylor, A. W., & Leenen, F. H. (1989). Effects of beta 1- vs. beta 1 + beta 2-blockade on exercise endurance and muscle metabolism in humans. Journal of applied physiology (Bethesda, Md. : 1985), 66(2), 548–554. https://doi.org/10.1152/jappl.1989.66.2.548

Head A. (1999). Exercise metabolism and beta-blocker therapy. An update. Sports medicine (Auckland, N.Z.), 27(2), 81–96. https://doi.org/10.2165/00007256-199927020-00002

Tesch P. A. (1985). Exercise performance and beta-blockade. Sports medicine (Auckland, N.Z.), 2(6), 389–412. https://doi.org/10.2165/00007256-198502060-00002

Brantigan, C. O., Brantigan, T. A., & Joseph, N. (1982). Effect of beta blockade and beta stimulation on stage fright. The American journal of medicine, 72(1), 88–94. https://doi.org/10.1016/0002-9343(82)90592-7

Archer, C., Wiles, N., Kessler, D., Turner, K., & Caldwell, D. M. (2025). Beta-blockers for the treatment of anxiety disorders: A systematic review and meta-analysis. Journal of affective disorders, 368, 90–99. https://doi.org/10.1016/j.jad.2024.09.068

Hartono, E. M. A., Saputra, F. F., Permata, A. A. S., & Wibowo, J. G. (2024). Beta-blocker efficacy for intra- and interdialytic hypertension patients: a systematic review and meta-analysis. International urology and nephrology, 56(7), 2279–2289. https://doi.org/10.1007/s11255-024-03973-2

World Anti-Doping Agency. (2024). The 2025 Prohibited List: International Standard. WADA. https://www.wada-ama.org/sites/default/files/2024-09/2025list_en_final_clean_12_september_2024.pdf

Grandi, E., & Ripplinger, C. M. (2019). Antiarrhythmic mechanisms of beta blocker therapy. Pharmacological research, 146, 104274. https://doi.org/10.1016/j.phrs.2019.104274

Conviser, J. M., Ng, A. V., Rockey, S. S., & Thomas, D. P. (2017). Cardio-protection afforded by β-blockade is maintained during resistance exercise. Journal of science and medicine in sport, 20(2), 196–201. https://doi.org/10.1016/j.jsams.2016.01.003

García-Arnés, J. A., & García-Casares, N. (2022). Doping and sports endocrinology: anabolic-androgenic steroids. Revista clinica espanola, 222(10), 612–620. https://doi.org/10.1016/j.rceng.2022.09.003

Wenbo, Z., & Yan, Z. (2023). The Uses of Anabolic Androgenic Steroids Among Athletes; Its Positive and Negative Aspects- A Literature Review. Journal of multidisciplinary healthcare, 16, 4293–4305. https://doi.org/10.2147/JMDH.S439384

Docherty J. R. (2008). Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). British journal of pharmacology, 154(3), 606–622. https://doi.org/10.1038/bjp.2008.124

Ferrara N, Komici K, Corbi G, Pagano G, Furgi G, Rengo C, Femminella GD, Leosco D and Bonaduce D (2014) β-adrenergic receptor responsiveness in aging heart and clinical implications. Front. Physiol. 4:396. https://doi.org/10.3389/fphys.2013.00396

Avois, L., Robinson, N., Saudan, C., Baume, N., Mangin, P., & Saugy, M. (2006). Central nervous system stimulants and sport practice. British journal of sports medicine, 40 Suppl 1(Suppl 1), i16–i20. https://doi.org/10.1136/bjsm.2006.027557

Rozec, B., Noireaud, J., Trochu, J. N., & Gauthier, C. (2003). Place of beta 3-adrenoceptors among other beta-adrenoceptor subtypes in the regulation of the cardiovascular system. Archives des maladies du coeur et des vaisseaux, 96(9), 905–913.

Clarkson, P. M., & Thompson, H. S. (1997). Drugs and sport. Research findings and limitations. Sports medicine (Auckland, N.Z.), 24(6), 366–384. https://doi.org/10.2165/00007256-199724060-00003

Queen, L. R., & Ferro, A. (2006). Beta-adrenergic receptors and nitric oxide generation in the cardiovascular system. Cellular and molecular life sciences : CMLS, 63(9), 1070–1083. https://doi.org/10.1007/s00018-005-5451-2

Antonelli, A., Torchio, R., Bertolaccini, L., Terzi, A., Rolfo, F., Agostoni, P., Gulotta, C., Brusasco, V., & Pellegrino, R. (2012). Contribution of β-adrenergic receptors to exercise-induced bronchodilatation in healthy humans. Respiratory physiology & neurobiology, 184(1), 55–59. https://doi.org/10.1016/j.resp.2012.07.007

Sheehan, M. W., Brammell, H. L., Sable, D. L., Nies, A. S., & Horwitz, L. D. (1983). Effect of beta-adrenergic blockade on circulating catecholamines and dopamine-beta-hydroxylase activity during exercise in normal subjects. American heart journal, 105(5), 777–782. https://doi.org/10.1016/0002-8703(83)90240-5

Johnson M. (1998). The beta-adrenoceptor. American journal of respiratory and critical care medicine, 158(5 Pt 3), S146–S153. https://doi.org/10.1164/ajrccm.158.supplement_2.13tac110

do Vale, G. T., Ceron, C. S., Gonzaga, N. A., Simplicio, J. A., & Padovan, J. C. (2019). Three Generations of β-blockers: History, Class Differences and Clinical Applicability. Current hypertension reviews, 15(1), 22–31. https://doi.org/10.2174/1573402114666180918102735

Wallukat G. (2002). The beta-adrenergic receptors. Herz, 27(7), 683–690. https://doi.org/10.1007/s00059-002-2434-z

Ljungqvist A. (2017). Brief History of Anti-Doping. Medicine and sport science, 62, 1–10. https://doi.org/10.1159/000460680

Oliver, E., Mayor, F., Jr, & D'Ocon, P. (2019). Beta-blockers: Historical Perspective and Mechanisms of Action. Revista espanola de cardiologia (English ed.), 72(10), 853–862. https://doi.org/10.1016/j.rec.2019.04.006

Tsai, S. W., Huang, Y. H., Chen, Y. W., & Ting, C. T. (2015). Influence of β-blockers on heart rate recovery and rating of perceived exertion when determining training intensity for cardiac rehabilitation. Journal of the Chinese Medical Association : JCMA, 78(9), 520–525. https://doi.org/10.1016/j.jcma.2015.05.009

Frei, K., & Truong, D. D. (2022). Medications used to treat tremors. Journal of the neurological sciences, 435, 120194. https://doi.org/10.1016/j.jns.2022.120194

Motiejunaite, J., Amar, L., & Vidal-Petiot, E. (2021). Adrenergic receptors and cardiovascular effects of catecholamines. Annales d'endocrinologie, 82(3-4), 193–197. https://doi.org/10.1016/j.ando.2020.03.012

Cero, C., Lea, H. J., Zhu, K. Y., Shamsi, F., Tseng, Y. H., & Cypess, A. M. (2021). β3-Adrenergic receptors regulate human brown/beige adipocyte lipolysis and thermogenesis. JCI insight, 6(11), e139160. https://doi.org/10.1172/jci.insight.139160

Brodde, O. E., & Leineweber, K. (2005). Beta2-adrenoceptor gene polymorphisms. Pharmacogenetics and genomics, 15(5), 267–275. https://doi.org/10.1097/01213011-200505000-00001

Juhlin-Dannfelt A. (1983). beta-Adrenoceptor blockade and exercise: effects on endurance and physical training. Acta medica Scandinavica. Supplementum, 672, 49–54. https://doi.org/10.1111/j.0954-6820.1983.tb01613.x

Van Baak M. A. (1988). Beta-adrenoceptor blockade and exercise. An update. Sports medicine (Auckland, N.Z.), 5(4), 209–225. https://doi.org/10.2165/00007256-198805040-00002

Published
2025-12-19
Citations
How to Cite
Szymon Rudawski, Magdalena Zięba, Magdalena Morytko, Maja Elertowicz, Mikołaj Moskwa, Patrycja Herod, Aleksandra Wójciak, Kateryna Shtohryn, & Hubert Gugulski. (2025). BETA-BLOCKERS IN SPORT: PHYSIOLOGICAL EFFECTS, PERFORMANCE IMPLICATIONS AND REGULATORY PERSPECTIVES. International Journal of Innovative Technologies in Social Science, 3(4(48). https://doi.org/10.31435/ijitss.4(48).2025.4356

Most read articles by the same author(s)