This is my first post but I’ve been lurking around here for a while and really enjoy coming here and getting all kinds of great info and funny stories as well. I have a question I hope some fellow triathlete may have dealt with before.
Does anyone out there have any experience with different types of medication for controlling blood pressure? A couple of years ago I was diagnosed with high blood pressure and was prescribed a beta blocker. Stupid me never asked any questions about the medication, I was just really scared at the time (it was really high) and took what they told me to take. It has been very effective for me in controlling my blood pressure, but now I wonder if it is the right thing for me to take as an endurance athlete.
After finally getting around to getting my personal trainer certification, one of the things I learned was that people who take beta blockers can’t get an accurate reading with a heart rate monitor since a beta blocker works by lowering your heart rate. Doh! A big light bulb went off in my head- no wonder I was struggling to work out at my previous heart rate levels before I began taking the medication. I just never connected the two together. This may sound strange but in my races I did last year I would always feel like my heart just couldn’t keep up with my body- I had plenty of muscular endurance but just couldn’t go as fast as I felt I had in the previous years. It was as if my heart hit a wall and would not allow me to go any faster.
I am now wondering if this is just a metal thing or if by having my heart rate lowered by the medication is causing me to feel this way when I race. Is there another blood pressure medication that would be better for me to take as an endurance athlete? I already asked my doctor and needless to say he was clueless about my situation. I am now looking for a sports doc so I can get some answers to my questions, but in the meantime I would like to hear from anyone who might have encountered a similar situation. My first race is coming up in a few weeks so I’ll see if the feeling carries over from last year. I had to take some time off from training due to the birth of my daugther last year and am just now getting back into form. I have felt fine training, but doing an all out effort in a race is when I’ll know for sure. I always felt fine training before, i just was frustrated by the fact I couldn’t get my heart rate up to where I was used to it being before I started the medication.
i take accupril which is an ace-inhibitor. my doc is very triathlete/aware, having been an on-site medic at kona in the past, and he said don’t worry, shouldn’t affect me at all. i don’t have any side-affects, however i take a very small dose (20mg), so that may have something to do with it.
A little background: 50 year old male, approx. 30 years of endurance sports (mostly running), family history of heart disease, high bp for most of my life but doctors never treated it because I had no indications of negative effects (not overweight, no shortness of breath, not a smoker, no chest pains). Finally decided I needed to do something because 160/90 is just not good for the old arteries. After much testing my cardiologist put me on Diovan and Hydrochlorathiazide. BP is now pretty consistently 145/64 give or take. Still not perfect, but the doc seems satisfied enough that he said he no longer needs to treat me - just keep taking the meds. By the way, I can’t get my heart rate much over 130 even during max efforts. Not sure what that means.
I’m a physician and everything you mentioned is true. I don’t specialize in endurance athletes but I can tell you what I know. Beta blockers will lower your heart rate. That should not change the readings on your heart rate monitor. But it will be harder for you to raise your heart rate to your prior levels so you won’t be able to sustain your maximum intensity like you used to. A lot of people usually get an ACE inhibitor like Zestreil (lisinipril) or Accupril or the like. You might want to ask your doctor about something like that instead. This is not without side effects but won’t affect your endurance heart rate as much. (however, make sure you stay well hydrated, as these drugs can affect your kidney and if you combine that with dehydration, you could have some trouble also) Some diurectics are also good for lowering blood pressure but that might make it difficult for you to stay well hydrated. You might have to experiement with your doctor.
Thanks for the info berndog, that’s exactly what I’m looking for, alternatives to what I am currently taking. For most people, having a lower heart rate is probably not bad, but for someone in an endurance sport I don’t think that it’s an ideal situation. I’ll look into these and see if the side effects are any worse that what I already deal with ( occasional lightheadedness if I get up too quick from lying down). Hydration is usually not a problem for me, I probably drink more than I really need, but you can’t be too careful here in the South when it’s in the 90’s and the humidty is almost that high as well.
Yes! Just this past winter I was put on Verelan - generally a high blood pressure medication, but for migraine headache prevention (see other thread). I was aware, from thorough research on the net, that this was a calcium channel blocker and that one of the effects was a lower heart rate. I began checking my waking HR and BP every day while on this.
My waking HR went from the mid 40’s normally to 30! It went back to normal after rising. At first I thought this might be a good thing for my training (and there was a thread about this here a few months back), but as it turned out - I was like a limp noodle out there on the bike. I could go long distances at an easy pace just fine, but I just could not work at all at higher effort levels. It was like someone had put a rev limiter on me.
After a month or so of Spring weather and being miserable about my riding, I stopped taking it, and within a week I felt like Superman. Sadly, it did help with migraine prevention, but the cure was worse than the malady.
Hi, I work as a ER doc and have a fair amount of experience with BP and BP meds. I would talk to your doc about an ACE-Inhibitor (such as lisinopril) or ARB (such as amlodipine). They tend to be better tolerated by athletes for the reasons noted above… B-blockers are notorious for problematic side effects including blunting HR response to exertion or stress. This is a pretty good site that explains different drug classes and side effects. http://www.aafp.org/afp/20020801/445.html
The most important thing is having a conversation with your doc about what works and doesn’t for you. Lifestyle mods such as low sodium diet and weight loss also have some efficacy. They should be excited to work with you to help your health.
take care,
k
No interest in any the above except keeping people well so I don’t have to work very hard!
I’M NO DOC SO THIS IS NOT MEDICAL ADVICE, but I am a pharmaceutical rep who talks to docs all day every day and one of my drugs is Altace (Ramipril) which is an ACE-I (angiotensin converting enzyme inhibitor). At present two of the most popular classes of medications to lower BP are ACE-I’s and ARB’s (angiotensin receptor blockers). In GROSSLY oversimplified terms the body makes a protein that causes your blood vessels to constrict. ACE-I’s prevent your body from converting this protein whereas ARB’s block the receptor site for this protein…two different methods of action that have the same end result, ie your blood vessels do not constrict. If blood vessels do not constrict it stands to reason that your blood pressure will be lower…at least that is usually the goal. If possible I would speak to a cardiologist (who knows LOTS about the heart and how it works) as opposed your general practioner (who knows a little about everything) as they are usually more up to date on the latest developments that impact the disease states that they specialize in. Ask your doc about the Heart Outcomes Prevention Evaluation (HOPE) trial and see if the results are relevent for you. Lastly, all ACE’s are not created equal according the the Annal of Internal Medicine 2004; #141:102-112.
I am 57 with the same story. After doing my own research because my doctor wouldn’t, I had to beg him to try an ACE Inhibitor. Solved the problem but not all ACE Inh. are the same. The doctors here on the forum are leading you in the right direction. Listen to them and you will be happy with your performance again.
Just to clarify for those interested…doughboy mentioned ARB (Angiotensin Receptor Blocker which is different from ACE-Inhibitors but work along the same pathway). doughboy mentions amlodipine but this is a calcium channel blocker which will lower your heart rate as do beta blockers. The lowering of your heart rate will prevent you from maximizing your effort (making you feel like the wet noodle) and I would suggest staying away from these classes of hypertensives–calcium channel blockers, beta blockers. Be very careful with diuretics as hydration is key to our sport and these drugs will make you lose h20 AND electrolytes. Hyponatremia is disasterous in endurance sports, especially for those who are overextending themselves. Hope this helps
Yes you are correct. Amlodipine is a Calcium channel blocker. Sorry- mixing classes… CCB’s are however relatively well tolerated by athletes as compared to Beta-blockers.
“… For these reasons, angiotensin converting enzyme (ACE) inhibitors (or angiotensin II receptor blockers in case of ACE inhibitor intolerance) and calcium channel blockers are currently the drugs of choice for recreational exercisers and athletes who have HTN.”
Thanks for all the great info everyone! Now I just have to find me a doc who is at least familiar with people who participate in sports and want to improve their health, rather than just take a drug and do nothing else.
