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The elevated outflow pressure gradient which is exacerbated by beta-adrenergic receptor stimulation. Inderal reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina. Propranolol may reduce the oxygen requirement of the heart at any level of effort by blocking catecholamine induced increases in the heart rate, systolic blood pressure, there is a risk of a rebound increase in blood pressure if the clonidine is stopped.