M
MitralMan
It used to be 176 (year prior to surgery). Now that I'm on Metoprolol, I don't think it's going much above 145. Should I use 145 as my new max for purposes of calculating my various target zones?
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Good Q!
Good Q!
Hi Mitral Man - I take it a really good sign you're asking those kinds of questions. How's the recovery going?
I don't take any beta blockers, but I was curious about the answer; I used to be a pharmacist back in the day and haven't fully recovered yet
I did a web search only to find a preponderance of "if you take beta blockers ask your Dr. what max HR s/b."
But I did find the abstract below. Not an ideal study - sample of 10 guys in good health, and only 5 got the drug. And the practical conclusion (if you don't have a physio lab) is just to figure it out yourself using RPE.
BUT - it does show a mean reduction of 20-ish beats at AeT and AnT, +/- 10 beats or so. What I found interesting is that power output and O2 consumption remained constant - suggesting that performance isn't impacted (not consistent w/ my own understanding, but I've got no personal experience).
***************
1: Eur J Cardiovasc Prev Rehabil. 2003 Aug;10(4):296-301. Related Articles, Links
Influence of beta-blocker use on percentage of target heart rate exercise prescription.
Wonisch M, Hofmann P, Fruhwald FM, Kraxner W, Hodl R, Pokan R, Klein W.
Department of Internal Medicine, Karl-Franzens University Hospital, Graz, Austria. [email protected]
BACKGROUND: Exercise is recommended for cardiac patients irrespective of beta-blockers. Percentages of maximal heart rate (%HRmax) and heart rate reserve (%HRR) are widely used to determine training intensities. The purpose of this study was to investigate the influence of chronic cardioselective beta blockade on the %HRmax and %HRR model. METHODS: Ten healthy male subjects randomly received oral placebo or beta-blocker bisoprolol (5 mg/day) for 2 weeks using a double-blind, crossover design. In the second week, the subjects performed a cardiopulmonary exercise test until exhaustion to determine the aerobic (AeT) and anaerobic (AnT) threshold. RESULTS: No significant differences were found for absolute and relative values of oxygen consumption, power output and ratings of perceived exertion at AeT, AnT and maximum workload. Mean HR was significantly (P<0.05) lower at rest (-15 +/- 5 bpm), AeT (-19 +/- 8 bpm), AnT (-22 +/- 10 bpm) and maximal workload (-19 +/- 11 bpm) with bisoprolol compared to placebo. Percentage of maximal heart rate (%HRmax) was significantly (P<0.05) reduced at rest (43 versus 39%), AeT (64 versus 60%) and AnT (86 versus 82%), a trend for a reduction was found for %HRR at AnT (75 versus 71%, P=0.07). CONCLUSIONS: Exercise prescription using %HRmax or %HRR methods are of limited accuracy for patients taking beta-blockers. Although %HRmax and %HRR are easy to determine and therefore attractive, we suggest that the most precise exercise prescription would depend on AeT and AnT. Percentages of maximal oxygen consumption or maximal workload or ratings of perceived exertion may be suggested as a substitute. Alternatively, upper limits for %HRmax and %HRR should be lower for patients taking beta-blockers.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 14555886 [PubMed - indexed for MEDLINE]
Good Q!
MitralMan said:
Hi Mitral Man - I take it a really good sign you're asking those kinds of questions. How's the recovery going?
I don't take any beta blockers, but I was curious about the answer; I used to be a pharmacist back in the day and haven't fully recovered yet
I did a web search only to find a preponderance of "if you take beta blockers ask your Dr. what max HR s/b."
But I did find the abstract below. Not an ideal study - sample of 10 guys in good health, and only 5 got the drug. And the practical conclusion (if you don't have a physio lab) is just to figure it out yourself using RPE.
BUT - it does show a mean reduction of 20-ish beats at AeT and AnT, +/- 10 beats or so. What I found interesting is that power output and O2 consumption remained constant - suggesting that performance isn't impacted (not consistent w/ my own understanding, but I've got no personal experience).
***************
1: Eur J Cardiovasc Prev Rehabil. 2003 Aug;10(4):296-301. Related Articles, Links
Influence of beta-blocker use on percentage of target heart rate exercise prescription.
Wonisch M, Hofmann P, Fruhwald FM, Kraxner W, Hodl R, Pokan R, Klein W.
Department of Internal Medicine, Karl-Franzens University Hospital, Graz, Austria. [email protected]
BACKGROUND: Exercise is recommended for cardiac patients irrespective of beta-blockers. Percentages of maximal heart rate (%HRmax) and heart rate reserve (%HRR) are widely used to determine training intensities. The purpose of this study was to investigate the influence of chronic cardioselective beta blockade on the %HRmax and %HRR model. METHODS: Ten healthy male subjects randomly received oral placebo or beta-blocker bisoprolol (5 mg/day) for 2 weeks using a double-blind, crossover design. In the second week, the subjects performed a cardiopulmonary exercise test until exhaustion to determine the aerobic (AeT) and anaerobic (AnT) threshold. RESULTS: No significant differences were found for absolute and relative values of oxygen consumption, power output and ratings of perceived exertion at AeT, AnT and maximum workload. Mean HR was significantly (P<0.05) lower at rest (-15 +/- 5 bpm), AeT (-19 +/- 8 bpm), AnT (-22 +/- 10 bpm) and maximal workload (-19 +/- 11 bpm) with bisoprolol compared to placebo. Percentage of maximal heart rate (%HRmax) was significantly (P<0.05) reduced at rest (43 versus 39%), AeT (64 versus 60%) and AnT (86 versus 82%), a trend for a reduction was found for %HRR at AnT (75 versus 71%, P=0.07). CONCLUSIONS: Exercise prescription using %HRmax or %HRR methods are of limited accuracy for patients taking beta-blockers. Although %HRmax and %HRR are easy to determine and therefore attractive, we suggest that the most precise exercise prescription would depend on AeT and AnT. Percentages of maximal oxygen consumption or maximal workload or ratings of perceived exertion may be suggested as a substitute. Alternatively, upper limits for %HRmax and %HRR should be lower for patients taking beta-blockers.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 14555886 [PubMed - indexed for MEDLINE]
M
MitralMan
Bill, you da man.
Bill, you da man.
This is exactly what I was looking for. Strange, I think, to find so little cross-referencing among cardioligists, cardio-thoracic surgeons and sports physiologists on post-surgical questions like this. But you found it!
Anyway: other than the fact that my arm is actually broken in TWO places, not one, things are going GREAT (even the breaks are OK -- one is a fracture, the other is clean through, but they don't hurt unless I do something really stupid, which I have thus far successfully avoided). On the other hand, I can't ride my bike for another two months or so, and no weight lifting until some time after that.
And of course, I can't row.
So I'm basically a stump. That's OK, too, though, because at least I can still walk. So today, I went out in the heat and humidity (85+), something I couldn't do for years (I'd literally pass out), and walked five and a half miles in hilly terrain with my dog. Polar transmitter strapped to my chest, speed+distance sensor laced to my foot. Average pulse, 91. 500' of vertical. My poor doggy was pooped in the end, and we both went home and took a nice long nap. But the fact that my dog wilted and I didn't (she's an incredibly fit German Shepherd) astounded me.
See my post in "post-surgery." I am a lucky man: cardiologist said this past week "your heart is normal, your valve is perfect, see you in a couple of years." My heart has shrunk over the past six months from 6.8cm to just about 5.
Miraculous stuff.
I'm starting to train for a five mile run in October -- looking for a personal best. First time I ran it I was very slow -- didn't realized I was symptomatic way back when. Second time I ran it was last year, and it was one of the reaons I went to see my cardiologist and had surgergy within three weeks. This walk was the first day of my training.
How's by you?
Bill, you da man.
This is exactly what I was looking for. Strange, I think, to find so little cross-referencing among cardioligists, cardio-thoracic surgeons and sports physiologists on post-surgical questions like this. But you found it!
Anyway: other than the fact that my arm is actually broken in TWO places, not one, things are going GREAT (even the breaks are OK -- one is a fracture, the other is clean through, but they don't hurt unless I do something really stupid, which I have thus far successfully avoided). On the other hand, I can't ride my bike for another two months or so, and no weight lifting until some time after that.
And of course, I can't row.
So I'm basically a stump. That's OK, too, though, because at least I can still walk. So today, I went out in the heat and humidity (85+), something I couldn't do for years (I'd literally pass out), and walked five and a half miles in hilly terrain with my dog. Polar transmitter strapped to my chest, speed+distance sensor laced to my foot. Average pulse, 91. 500' of vertical. My poor doggy was pooped in the end, and we both went home and took a nice long nap. But the fact that my dog wilted and I didn't (she's an incredibly fit German Shepherd) astounded me.
See my post in "post-surgery." I am a lucky man: cardiologist said this past week "your heart is normal, your valve is perfect, see you in a couple of years." My heart has shrunk over the past six months from 6.8cm to just about 5.
Miraculous stuff.
I'm starting to train for a five mile run in October -- looking for a personal best. First time I ran it I was very slow -- didn't realized I was symptomatic way back when. Second time I ran it was last year, and it was one of the reaons I went to see my cardiologist and had surgergy within three weeks. This walk was the first day of my training.
How's by you?
