I have my semi-annual comprehensive physical this month and fully expect to be put on hypertension meds. I have been fighting it for years but it seems inevitable as it just keeps going up no matter how fit I get of how much weight I lose. It’s just in my DNA. What are your experiences with these meds in terms of side effects for the endurance athlete? What drugs have you tried and which ones worked best/worst?
I was on Diovan 80 mg once a day. It had no effect on my training or racing at all. I also did not experience any side effects. Good Luck
I dont know what the meds themselves do, but having lower BP should theoretically increase the volume of bloodflow that reaches your muscles. BP is a measure of vascular resistance to blood flow. Your heart has to pump harder if there is more fluid resistance against your blood. By reducing resistance you should increase O2 delivery to your muscles without increasing blood flow (stroke volume x heart rate).
Is there a CARDIOLOGIST out there???
Hey last tri…
Have you tried giving up caffiene? I fought this battle every year during my flight physical, and then last year I just drank water as opposed to having my morning diet coke, and sailed through with no issues. I bet it would have been even lower had I given it up for a number of days prior.
Spot
Well, if a drug is in your future with your internist - ask for it to NOT be a beta blocker (their usual first response based on the original Framingham study) as this will hamper your performance. There are other options and for various reasons (ACE inhibitors (in fact, a new selective one is coming soon with less side effects like a cough), calcium channel blockers, etc.) that won’t impact your performance much, if at all.
Good luck!
You will be fine - just make sure your MD understands what you do and prescribes the right stuff. There are a lot of options. I went in for a company physical last year and was shooting 140/95 and my doctor took me through the whole deal and she is a very good marathoner. She said it could be done with no ill affect. I was not concerned because I have been a hyper reactor on the cuff for years (its a lack of control thing in the doctor’s office). And 6 weeks later of keeping a BP log she was convinced my BP is really around 110/60. So, I have no practical experience in the area of actually taking the drugs. You also want to make sure that any meds don’t affect your ability to get an erection. Best.
I can second the warning on beta blockers. Beta blockers and athletic performance are like oil and water. Not a good plan. I spent the majority of 10th grade asleep in class due to beta blockers.
These days I’m also borderline and I had a frank discussion with my doctor. Given my body type, and exercise schedule she concluded that the negative effects of medication outweight the negative effects of my current pressure. So we’ve decided to do nothing at this point. But two things might drop it down a bit for your next doctor’s visit: No caffine like someone else has mentioned, and make sure you’re hydrated. Dehydration will increase your blood pressure.
Whatever you decide, make sure it’s in consultation with your doctor!
Best of luck,
-J
Doc, do you have the nameof that new selective one?
Doc, do you have the nameof that new selective one?
Nope - not out just quite yet I was told. Just did surgery on one of the drug reps (Pfizer I think) and I was asking her about her job/drugs she has, etc. to get her mind off my dressing change as she was looking a little pale at the time : )
I’ll see if I can find it real quick online and edit the post if I find it …
edit: ah, Novartis (checked her chart, not Pfizer). Drug is Tekturna (a renin inhibitor)
I have always been good for plus 10 points when i see a white coat. I can usually counter this ( and for stuff like life insurance physicals) by a good workout right before a test. The workout usually brings me down to 120/75. When they catch you is at the dentist of chiropractor when someone slaps an unplanned cuff on you and you get a sky high reading. So I am going to deal with it honestly and openly and for all before I get myself into trouble. My main problem will be that the physical will be at a top notch place 3 hours from my house and the follow up care will likely be with my pathetic rural health system near my home.
I know a Pfizer regional sales guy. I’ll ask him also.
Been on lisinopril (zestril) for 6 months. Very low dose. (I’m 37) … It seems to have “taken the edge off” as my Dr. hoped, though maybe not enough (from 140/80 typically mid-day before meds to 130+/75 now) … Been around for 20 years, very cheap ($10/month) with minimal side affects (My mouth gets extra dry when I am thirsty, that’s it that I can tell) … Diovan is mild and helps, too, my sister is on it. We are both fit and not overweight, so for us its geneitic too … Our 65-year-old parents didn’t need meds until recently, so I guess it skipped a generation or something …
Hmmm, I’m not sure the dentist counts – that is white coat syndrome or worse (at least for me). When I went in for my Colonoscopy my BP was through the roof and I knew it was going to be so I kept a log for the previous 2 weeks before I went in and gave it to them. They just laughed and said most people are elevated before such a procedure. Have you kept a log with a calibrated cuff? My Dad was a Cardiologist and my sister works in open heart ICU. Both of them say the most accurate BP readings happen out in the parking lot. Medical personnel with a BP cuff have become a phobia for me and I admit I am a head case over this issue. They call hypertension the silent killer and I am not sure why. I can feel it in my head and when they pull out the cuff I can feel it go up. But pay no attention to me and follow your MD’s advice. And I would note given the sorry state of the public, most American’s would kill for 125/75.
we sound very similar. 120/75 is a short term deal after I work out. within a few hours more like 140/100 or occasionally higher.
I have been on lisinopril - an ACE inhibitor - for years. Natural history of hypertension is that lifestyle modifications (e.g., low sodium diet, weight loss, and aerobic exercise) can lower BP transiently, but they really will only delay the onset of requiring therapy - in other words, population studies show that the slope of your rise in BP may be lowered, and may start from a lower point as the result of your healthy lifestyle, but if it’s in your genes, it will eventually rise and merit treatment.
I have to support the avoidance of beta blockers, unless you have a tendency to certain kinds of cardiac arrhythmias - I find the ACE inhibitors (like lisinopril) pretty benign - no effect on training, racing, recovery, etc. The only side effect that most folks experience is a tendency to a dry cough. Also, I don’t like some of the vasodilators, as they can cause orthostatic changes if you are at all volume depleted.
Make sure your doc knows you’re an endurance athlete, if he decides to treat the BP.
The other thing to note is where you are in your season. During my annnual cycle, my BP (treated) peaks in January (e.g., the end of my post-season transition period) at about 125/85 - as my trailing level of intensity / volume is at a low and my weight peaks. By mid summer, my BP is usually 105/65 or 105/70. Keep that in mind.
Good luck!
Here’s another data point near the regression line. I’ve been taking hypertension meds for about 10 years. First try was a beta blocker. Ouch. I now take a combination ACE inhibitor and calcium channel blocker and a diuretic. They definitely do affect my performance, although it’s not huge. I’ve only been on the diuretic for about a year, and adding it did present some issues for proper hydration at longer distances. For what it’s worth, here’s what I do.
For workouts, I go ahead and take the stuff in the morning at least an hour before I go out. On race days, I wait until I’m finished. I think it makes a difference. I have no idea whether one, some or all are affecting performance. I did two halves last year, both of them fairly warm. No cramping issues at all, but I did switch to Gatorade Endurance. That said, I’d be pretty nervous about trying another full taking this rainbow of pills. May try it though.
David
Here’s a 2nd for the lisinopril. I’ve been on it for 2 yrs now, with no side affects, except I have a bit of a dry cough, as oldslowdoc mentioned. No problems for me though.
I’m in a similar situation. I take Diovan, Tiazac, and a low dose (12.5mg) HCTZ. Sometimes I’ll skip the HCTZ before an event or group bike ride. I think it makes me pee a lot. I don’t feel like the meds hamper my performance. Hypertension is fairly extensive in my family so I’ll likely be on it for the duration. I started in my late 30’s and my dad started in his forties. But most important, rely on the advice of your cardiologist.
Peace,
Rob
I’m in the same boat. About three months ago my doc put me on Narvask, a calcium channel blocker. I’ve had no side effects, but I haven’t been training very hard recently. It certainly helped my BP.
If it matters to you, make sure before you meet with your doc which meds are covered and at what rate by your insurance. There are lots of pretty-much equivalent-in-effect meds availables that vary widely in price. And it’s generally cheaper to get multiple months at once, so make sure your scrip allows you to do that.