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Metoprolol, a beta-blocker, is known to potentially cause exercise intolerance in patients with hypertension. This medication works by blocking beta-adrenergic receptors, leading to a decrease in heart rate and contractility. While this can be beneficial for managing hypertension and reducing the heart's workload, it can also limit the body’s ability to respond to physical exertion.

When a patient engages in exercise, the body typically responds by increasing heart rate and cardiac output to meet the increased demand for oxygen and nutrients. However, metoprolol dampens this normal physiological response, which can result in a reduced capacity to perform during physical activities. Consequently, patients may experience fatigue or shortness of breath during exercise, contributing to a sense of exercise intolerance.

Other antihypertensive medications, such as lisinopril, amlodipine, and hydrochlorothiazide, generally do not have the same significant effect on exercise tolerance. Lisinopril is an ACE inhibitor that primarily lowers blood pressure without typically causing decreased exercise capacity. Amlodipine, a calcium channel blocker, helps to relax blood vessels and improve blood flow and usually does not impair physical performance. Hydrochlorothiazide, a thiazide diuretic,