Metroporol reduction & exercise

[ctyguy]

Yesterday I had my 6-month checkup with my PCP and all the news was great coming out of there. He is pleased with my progress and said to just keep doing what Im doing. Yah for me !

One of the things he did was change my beta-blocker scrib from 100mg to 50mg. I took the new reduced amount yesterday for the first time. Today when I went out for my Saturday run I wore my heart monitor as usual but noticed that my heart rate was up around 160 bpm instead of the 140 - 145 it was prior the change. Have others experienced this ? I was kinda freaked out and actually stopped running a few times to let my heart rate drop back down but as soon as I started running again it was back up over 150. Im still wearing the monitor and it seems my resting rate is comparable to what it was before so Im just curious to what others have experienced when they changed dosages. Do I just let my body adjust ? Should I be concerned with my heart at 160 ? I have a mechanical valve and to be honest this is one of the reasons I chose it. I know that a tissue valve will wear out faster if you exercise alot and thats the lifestyle I want to lead without the worries that the more I push my heart rate the sooner Im going to end up back on the table. Not that I still couldn't, but that was part of my rational.

Have others seen a change in their heart rates when their dosage was reduced ? Should I be concerned ? I didn't "feel" any different when I was running other than the marginal panic attack when I glanced down for the first time and saw 163 on my watch !

 

[Bina]

I would taper down a bit more gradually....from 100mg you may want to take 75 mg for a couple of weeks, then see if you can still go down to the 50 mg. Cutting a BP med in half is drastic.

 

[Duff Man]

I agree... go a little slower with the taper man. Withdrawing quickly from beta-blockers is generally not so good. It causes rebound hypertension and sensitivity to exercise, etc. Also, do you remember what your heart rate was pre-surgery for the same kind of run?

 

[ponygirlmom]

Did your doctor ever tell you that you should keep your heart rate under a certain number, whether at all times, or for extended times? Does your doc have you keep track of how quickly your exercising heart rate falls when you stop exercising?

I think you will be much more confident if you get some guidelines like these, plus your doctor may have definite opinions about these subjects!

 

[ctyguy]

Thanks for the feedback folks. I had asked my PCP about it and he is the one who suggested cutting the dosage in half. What Im going to do is simply monitor my heart rate when I exercise and see how my body adjusts to the new dosage. I didn't have any discomfort or anything along those lines when I was running so Im thinking its just going to take some time for my body to adapt.

Aaron - You asked what my heart rate was prior to surgery when I ran. Thats what got me to the Cardiologist in the first place because I would get 2/10ths of a mile in and I had SOB and chest pains. Probably a year or two before that I could run 2 or 3 miles but it was really difficult, my stenosis evidently was picking up steam over the last few years. Honestly I had no clue that I had an issue and I didn't ever monitor my heart rate. I was 15 days from diagnosis to "slice and dice". So to answer your question I really don't have a frame of reference. My PCP did say that the reduction should help me from an exercise perspective and that higher doses of a beta-blocker does inhibit exercise. With the reduction my legs should perform better because with the higher heart rate more blood will pump to the extremities, more oxygen to the major muscle groups, etc...

Ponygirl - I was told to keep my heart at 140 bpm when I took a stress test at about 4 months post op. But that was when I was taking a 100mg dosage. My PCP didn't say anything about a new threshold. I took the stress test at the coumadin clinic and I have my 6 month chat with the doctor there set for two weeks from now. That will definitely be a question I can ask, thats a good suggestion, thanks !

I guess Im looking to see anyone who is roughly my age/body size who went with a mechanical valve and who runs to see what their numbers look like. I would expect their experience to be something I can compare against.

 

[Lionheart]

I have a mechanical valve and to be honest this is one of the reasons I chose it. I know that a tissue valve will wear out faster if you exercise alot and thats the lifestyle I want to lead without the worries that the more I push my heart rate the sooner Im going to end up back on the table. Not that I still couldn't, but that was part of my rational.

Hi Scott,

Not to sidetrack this tread but from what I've read it's not activity or exercise that affects the life of a tissue valve, rather I thought it was age. So the older you are, the longer the tissue valve will last. Obviously most younger patients are more active but I would be interested in seeing any papers or information that relate a lower tissue-valve life with higher activity level. I find it interesting because for the same reason as you, that is, wanting to keep an active lifestyle, I chose a tissue valve. I'm not sure, but I may be a little older than you. By the way, we had the same surgeon and my surgery was about a week after yours.

Thanks for your many posts about your physical activity. I follow them often as an inspiration for my exercise.
Take care,
John

 

[jds]

Beta Blockers are supposed to lower HR.

Beta Blockers are supposed to lower HR.

Beta Blockers are supposed to lower HR.

So the reduced dose would be expected to have less effect and, unsurprisingly, your heart rate went up.

If you do not already have one, ask your cardio or PCP what your target HR should be and try to (mostly) stay under that. The very simple rule of thumb is 220 - age.

I cut out metoprolol and switched to lysinopril (an ACE inhibitor) as an anti-hypertensive because I did not want a cap on my HR. I was only on 25mg of metropolol so I'm not sure it was a big deal for me.

As your condition improves, you'll be able to work harder with your heartbeat under the target rate.

John

 

[ctyguy]

Not to sidetrack this tread but from what I've read it's not activity or exercise that affects the life of a tissue valve, rather I thought it was age. So the older you are, the longer the tissue valve will last. Obviously most younger patients are more active but I would be interested in seeing any papers or information that relate a lower tissue-valve life with higher activity level. I find it interesting because for the same reason as you, that is, wanting to keep an active lifestyle, I chose a tissue valve. I'm not sure, but I may be a little older than you. By the way, we had the same surgeon and my surgery was about a week after yours.

Lionheart. From my understanding age is used by doctors to help make a recommendation (tissue or mechanical) amongst other variables of course. If you put a tissue valve in a 20 year old odds are that valve will wear out in fairly short order. A 20 year old is going to have a much higher resting heart rate than someone in their 50s or beyond. And certainly a 20 year old is by and large going to be much more active and will put his/her heart through alot more if you simply compare lifestyles. As a person ages generally their resting heart rate slows so a tissue valve will last longer simply because it is being used less from a bpm perspective. That logic makes perfect sense to me and that is why I chose mechanical. I would also be curious to see if there are any papers or studies that compare the two. Im going to post a new thread and see what others think about the topic.

 

[Lionheart]

Thanks Scott,

The causal relationship between age and tissue-valve life is one that I don't understand very well. From what I've read it was age and not activity that defined the life of the valve, but obviously even that varies with individuals. But what you said makes sense that the younger the person the more active the heart. Still, it would be interesting to see if there are studies that compare young (or older) tissue valve recipients that are either 1) very active or 2) very inactive and whether valve life is related to either activity level.

I look forward to the discussion in the other post.
Thanks again.
John