Beta blockers and exercise

[Paleowoman]

I'm doing my cardio rehab exercise programme every other day at home. Doing some experimentation with when I take my beta blocker in relation to the work out, whether to have it earlier in the day before the work out or later after the work out. I'm taking Atenolol 12.5mg once a day. It still has an effect on my heart rate even though I don't think it's a very high dose.

- if I don't take a beta blocker before I exercise then my heart rate is a bit high to begin with (80s) and gets up to about 140bpm on the most strenuous exercise
- I'm only supposed to go to around 117bpm but that was fixed when I had taken a beta blocker earlier in the morning
- when I take a beta blocker earlier in the morning it's more difficult to get my heart rate up to 117, more difficult even than getting my heart rate up to 140 when I don't have the bb before the work out
- seems to me that having a beta blocker means my muscles have to work harder to get my heart rate up to the target rate ! Not taking the beta blocker it's easy to get up to the target rate so my muscles don't have to work so hard !
- I want my muscles to work hard as I lost a ton of muscle after OHS and want to rebuild......so......it seems to me that taking the beta blocker means I'm working harder so why do some people say that taking a bb means they can't work hard :confused2: Am I missing something ?

And what should I do about when to take the bb to be best for my heart and for my other muscles ?

 

[mainframe]

I had this discussion with my cardio after I was put on a beta blocker and had the same frustration working out, not being able to get my heartrate up to pre beta blocker exercise levels. He simply stated that I'd have to figure out another way to determine my exercise exertion level other that heartrate. Now I know more or less how hard I'm working based on my breathing. YMMV.

 

[Paleowoman]

Confusing isn't it

To be honest I'm not really happy about being on a beta blocker. I would like to know much more about them. I have searched the internet for hours and everything I read about them is related to either hypertension, atrial fibrillation or anxiety. I can find no articles about them in relation to cardiac surgery other than their use perioperatively. I have never had any atrial fibrillation but I understand they are prescribed straight away when people have heart surgery to prevent atrial fibrillation. I asked the honorary spokesman for the Society for Cardio Thoracic Surgery (in the UK) who is a cardio thoracic surgeon, for how long beta blockers are normally prescribed post surgery and he said six weeks if there's no AF or high blood pressure ! So why aren't we all taken off these things ? It would seem that it is entirely dependant on the whim of the surgeon or cardiologist, that there is no definitive protocol regarding post cardiac op beta blockade.

 

[AZ Don]

I'm still prescribed a beta blocker (metoprolol) and it's my understanding it is because I am at risk for (another) aortic aneurysm due to my BAV though I did have 2 bouts of Afib post surgery. My Cardiologist would like me to continue with it indefinitely, but I find the evidence that it is useful in the prevention of aneurysm is not compelling: http://aorta.scienceinternational.org/volume-1-2013/toc/21-state-of-the-art-reviews/58-07

I was also advised to keep my heart rate below a max of 120 - 130, again because of risk of aneurysm. The beta blocker does help with this and I haven't had any side effects so for now I've continued with it. I am also taking Losartan which I think is more likely to be helpful in preventing aneurysm.

I suggest you ask your Dr. why he/she wants you to continue on the Beta Blocker and what evidence is there to support this.

 

[Paleowoman]

I haven't got an aneurysm AZ, but I can tell you something strange: I took my beta blocker today around 2 pm, so that's four hours ago, so it will be at full strength presumably now, and just now my heart rate went quite low, around 65 and I felt it was really strong so took my blood pressure which turned out to be going high at 130/90. When my pulse goes fast my blood pressure is usually low. So if I had an aneurysm I think to have a low heart rate but high blood pressure would be worse than having fast heart rate and low blood pressure...but I'm not a doctor. And sometimes that doesn't happen, sometimes I get low pulse and low blood pressure, and sometimes high pulse and high blood pressure. I don't know...these beta blockers worry me, things were more stable before I ever had one ! But who knows what I'd be like without them...and do we get dependant on them ?

 

[mbeard]

I can second AZDon for the reason he is taking beta blocker. (aortic aneursym) . But Paleogirl , I know,you are a weight lifter, and it is hard not being able to go back to what you love, without being able to depend on your heart rate to measure by. Especially since weight lifting is anaerobic . You want to know what your maximum heart rate CAN be.

Two things. I have gone to light weights, (10lbs), one side at a time, and concentrated on higher reps, breathing throughout. This has been my BAV and aortic aneurysm diagnosis.

Secondly, my husband has been a devoted weight lifter for 40 years. He is 61. He fell last week, and broke his elbow, taking the tricep muscle with it. He had surgery to repair, and is now doing simple, really simple exercises to get his strength back.

He is like you, determined. You will figure this out. I know it.

 

[Agian]

I was also advised to keep my heart rate below a max of 120 - 130, again because of risk of aneurysm. The beta blocker does help with this and I haven't had any side effects so for now I've continued with it. I am also taking Losartan which I think is more likely to be helpful in preventing aneurysm.

But hasn't your aneurysm been fixed? Why would you get another one?

 

[AZ Don]

But hasn't your aneurysm been fixed? Why would you get another one?

For the same reasons I got the first two - I actually had two separate ones in my root and ascending aorta. I clearly have the capacity to develop aneurysms, thanks in part to the higher risk that my BAV brings. For those with a BAV I think the risk is higher in the root and ascending aorta but that doesn't rule out the possibility of an aneurysm further down the line, past my graft. Both my surgeon and cardiologist shared this concern. I think it is rare but not unheard of for those with a repaired aneurysm to develop another - I have heard of several cases.

 

[Paleowoman]

I can second AZDon for the reason he is taking beta blocker. (aortic aneursym) . But Paleogirl , I know,you are a weight lifter, and it is hard not being able to go back to what you love, without being able to depend on your heart rate to measure by. Especially since weight lifting is anaerobic . You want to know what your maximum heart rate CAN be.

Two things. I have gone to light weights, (10lbs), one side at a time, and concentrated on higher reps, breathing throughout. This has been my BAV and aortic aneurysm diagnosis.

Secondly, my husband has been a devoted weight lifter for 40 years. He is 61. He fell last week, and broke his elbow, taking the tricep muscle with it. He had surgery to repair, and is now doing simple, really simple exercises to get his strength back.

He is like you, determined. You will figure this out. I know it.

Hi mbeard,

I'm sure I'll be able to go back to the kind of weight lifting I enjoyed once my sternum has healed I've never depended on knowing my heart rate when I'm (was) doing weight lifting, I just go by the number of reps I can do at superslow speed ("time under load"), breathing throughout, and the amount of the weight, which I would record each session. I'm sure my heart rate went really high, though I never measured it. What I'm doing with cardiac rehab is aerobic and very different. The confusing thing is the beta blockers. As I said, I would never measure my heart rate when I did weight lifting but the cardiac nurse has me measuring it for this rehab - I think it's a kind of interval training for the heart :thumbup: But if the beta blockers affect my heart rate it's tricky to know what's real !

I hope your husband recovers quickly ! The rheumatologist I'm under for osteoporosis is a weight lifting champion and he tore his rotator cuff.....he's still doing heavy lifting but not quite so heavy now.

 

[epstns]

Hi, Anne,

As you probably have read in other posts, I am still taking a beta blocker, and if my cardio gets his way, I will be forever. He wants me on it to try to prevent afib, although my last recorded afib of any significance was only a month post-op. We have negotiated two dosage reductions that have enabled me to return to some level of exercise, and I guess I'll go with that if that's as far as he is willing to go.

Sometimes we have to make trades to get the things that are really important to us. I get more years on the right side of the grass, but I can't exercise as hard as I used to.

 

[RobThatsMe]

Hi Anne,

I also take 100 mg of Atenolol, a BB, a day, and still work out. I do build muscle.
bpm I do not feel matters to much in building up muscle.
Increased bpm will increase your heart rate as well as "burn" more calories. Great if you are trying to lose weight by walking, jogging, or running. But when it comes to resistance training, and weight lifting to increase muscle mass, I am a firm believer that it can be done while taking a BB.

Here is some addional info that was passed on by a nurse several yrs ago.

Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Hello,
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN

 

[Paleowoman]

Rob - thanks for that info, that is kind of what I was thinking, that my starting and ending heart rate are what's important and that it might be different depending on the time of day or if I have or haven't taken the beta blocker I too don't think my heart rate has anything to do with muscle building !

Steve - I wish I knew whether it was true or not that the beta blocker would give more years this side of the grass !

 

[Garserin]

Anne, when I was attending cardiac rehab sessions, the therapist had me exercise at 20 - 30 bmp over resting heart rate. At that time I was taking 50 mg of metoprolol daily. Later on, when I started running at age 63 my dosage had been reduced to 25 mg and I had no problem getting my HR up into the 170s. I wonder how high it would have gone without a BB. Like Steve and Rob I will probably be on a BB for life, however I have not found it to be limiting or causing problems in any way.
Best wishes for a complete recovery,

Elfie

 

[Agian]

For the same reasons I got the first two - I actually had two separate ones in my root and ascending aorta. I clearly have the capacity to develop aneurysms, thanks in part to the higher risk that my BAV brings. For those with a BAV I think the risk is higher in the root and ascending aorta but that doesn't rule out the possibility of an aneurysm further down the line, past my graft. Both my surgeon and cardiologist shared this concern. I think it is rare but not unheard of for those with a repaired aneurysm to develop another - I have heard of several cases.

Thanks for your answer.

I was put on Atenolol 50mg in the morning. I found that my heart-rate would increase by evening. My cardiologist suggested Metoprolol 50mg twice daily. Sure, it dropped my HR, but the effect was short-lived. Before my second dose, it would be over 100. Now, I'm taking 25mg twice a day of Atenolol and things are going well. It doesn't bother me. I assume I'll be taking it forever. No problems. If your BB is causing you issues, you could always suggest to try another one :thumbup:

 

[mbeard]

I am taking 12mg daily of atenolol. If I forget it, ( I take it in the afternoon), my heart bangs and hurts. This medication is good for me. I work out in the morning, but I feel the heart pounding early in the afternoon. I am in the waiting room with a BAV and aortic aneurysm (4.2).