Carvedilol and Heart Rate / Biking, jogging

[scg]

I'm (52 years old) celebrating my 12th week post surgery for Mitral Valve Repair which was successful...performed at Duke May 14th. My resting heart rate had been high (90-100) beats per minute post surgery, (presurgery 45-50bpm) so they put me on Carvedilol (9.37mg) twice a day to reduce it. I also have prehypertension, so it was used to reduce my BP as well. Only drug besides aspirin. I've been riding my bike regularly for the last few weeks, getting in a 25miler last weekend. Walking up to 5 miles with some 100 yard jogs thrown in. Seems like once I get my HR up to 130-135 on the jogs, I just can't run anymore and have to recover. Same with the bike on hills...if I get my HR up above 135 for any length of time, I'm toast...but if I go very slow keeping my HR below 115, I can go for a long time.

6 years ago I was doing Triathlons and had a VO2 of 55.8...regularly riding with average HR of 131 with peaks of 161 plus. Granted I was 6 years younger, but has anyone else had similar experience with Carvedilol or post surgery reduction of peak HR? Looks like I'm on the drug for another 2 months so looking for a training regimen that isn't going to stress the ticker too much but get me back to 17-20mph rides as opposed to 14-15mph rides. I know...still early yet. Yes...I'm in Cardiac Rehab as well, so will be asking the same question, but like Doctors sometimes going through the motions but don't have the answers that help. Better to talk to others that have gone through the same thing.

 

[AgilityDog]

Hate to break it to you, but those beta blockers are intended to reduce your heart rate. So, yeah, you're going to experience fatigue if you try to push the HR. My cardio says not to believe the calorie counters on my HRM or my elliptical, because in order to get my HR up high, I have to work MUCH harder than anyone else, because of the beta blockers.
I suspect you are working harder than you realize to get your HR to 135, resulting in fatigue. Also, if you are working much harder, it's going to require more recovery time.

Besides. 12 weeks!!! Cee-ripes. I was barely getting back to regular exercise at 12 weeks. I think I started rehab at 9 weeks, both rounds.

Try to remember you've been hit by a truck. Give yourself a little more time to recover before you push things. If you DO get off the beta blockers (and that is not guaranteed) in a couple months, then fine, push a little more. But give yourself 6 months before you try to get back to full pre-op/pre valve issue training.

 

[tprice54]

Yup, those BB's will stop you! I would make an effort to get off them if medically possible. There are much better drugs to treat hypertension, especially for athletes. Work with your doctor to see if and when you can drop them.......you will see the difference quickly. ALso, do not juts stop them without medical ok...you need to wean off of BB's.

 

[scg]

I'm on them because my resting heart rate was so high after surgery. It was the only drug that treated both the high bp as well as dropped the rate. Tprice54, what are the best drugs for athletes for treating hypertension? I've been on metatoprol and lisinopril prior to surgery.

 

[tprice54]

Ace inhibitors(like lisinopril) are ok, they keep blood vessla open, and don't allow them to constrict which keeps the bp lower...just watch out if you dehydrate. I get very light headed because of them. If you need BB's them fine, but getcthenlowest dose possible. I got off mine at about 4 months.

 

[SheldonGrunwald]

I am also finding that beta blockers really limit aerobic exercise dramatically. I am on 25mg/day of metoprolol along with 300mg rythmol(propafenone) three times a day. Before my surgery a heart rate of 120 was a very easy aerobic effort, now it is very difficult. I max out at about 130 and then I have to start walking.
I know it is important to be on the medications because I went into afib 3 time in the first three months after surgery. Hopefully I won't have to be on them permanently.
I have heard some people say if they exercise in the morning at take the medications at night they have a little more tolerance for exercise, but I haven't found this to be true in my case.
Unfortunately these medications aren't pleasant, but they are still better than afib

 

[scg]

Thanks! All good info. I rode my second 36miler on the bike this weekend and although still slow recovered much better today. Partly hydrating better than last weekend. Makes a huge difference.

 

[offwego]

Thanks! All good info. I rode my second 36miler on the bike this weekend and although still slow recovered much better today. Partly hydrating better than last weekend. Makes a huge difference.

Sounds like you are doing incredibly well. I had Mitral Valve repair in November and I foolishly didn't do rehab, which would have actually been fine, IF I was more diligent about aerobic exercise. Instead I thought I could just walk rather casually and it would be enough...Unfortunately that's not the case for me and my echo showed an ejection fraction of around 40%..

I was put on 320mg Diovan (max dose) and am on 12.5 Coreg 2x a day now and will slowly increase it to 25mg (UGH) 2x a day...I joined the gym two weeks ago and am shooting for 4x a week on treadmill or some other machine/bike.

My HR prior to surgery was very high.. a moderate walk would get it to 135 bpm!

Now, at 125bpm after running at 5mph, is exhausting...I can only do a couple of minutes before slowing it down to fast walk of 4mph.

My cardiologist suggested to keep HR at around 110 or so.

I think from what I've read and feel the Coreg can be reducing our HR by easily 20%, which makes sense to me.

You're lucky you will be getting off of it so soon, I'm jealous! I'm on doctors orders to get to the gym 4x a week and he's very confident my EF will improve and will eventually wean me off these meds but they make me tired and my dreams are really vivid and sorta exhausting...

But this is all a good problem to have compared to another OHS (this was 2nd to fix MR both times).

Keep up the good work, it's inspiring.