exercise and beta blockers

[Bettie]

I'm 67 years old and I just returned from a check-up at the Cleveland Clinic. It has been a year since my septal myectomy. Dr. Lever said that the echos and ekg were all right , but that I didn't do as well on the treadmill stress test as I did before having the myectomy. I was surprised because I thought that I had done much better. I seemed to be able to do it without so much effort and I stayed on for 8 1/2 minutes. The last 30 sec. was on a very steep incline. Then Dr. Lever said that his statement wasn't quite right because it showed better endurance when I stayed on the treadmill that long. I think that he was upset with the heart rate. I have always had a slow heart rate and I just take 25 mg of toprol XL. He said that he could see that I was taking some beta blocker., but he would like to see me get my heart rate up to 110 or 120 bpm. At the time of the first treadmill test I was not on beta blocker and my heart rate got up to139 bpm and my blood pressue got up to 194/84. I'm wondering how many of you can get your heart rate up to 100 or a little above that when you are on beta blocker.
My heart doctor at Ft.Wayne was reluctant to set up an exercise program and finally said that walking was the best thing that I could do. This past year I continued going to Curves and water aerobics. Dr. lever is going to set up an exercise program for me.

Bettie

[Lisa Salberg]

With exercise I can get my rate up to about 110 and I am on BB's.
At rest I am around 60.

Lisa

[Glen Beamish]

With moderate exercise I get to 100 or just above.
If I push it I can get to 110 - 120, but I can not sustain that for very long.
So I have to do short bursts and my bike has that type of programming on it.
My resting rate is 50 - 55.

[Linda]

Bettie - How do you think you are doing? How are you feeling this past year? If you are doing Curves and water aerobics, you sound pretty active. Linda

[Largehearted]

Bettie.

I have to work heard to get my heart rate above 100. I am on a rather large dose of BB to help control a-fib. I can get it up to about 105 if I push.

Leon

[RPMelia]

I'm 62 and on 100 mgs of Toprol xl - increased from 50 mgs last fall after quickly reaching my age limit heart rate on my echostress treadmill evaluation.

My resting rate is about 60.

I wear a Polar Heart Monitor when I exercise or do yard work. I noticed while raking leaves that I easily hit 140 -- even on the 100 mgs.

I also see my bp drop when I exercise or do heavy work.

I've become much more alert to my symptoms since my provocable HCM diagnosis at age 59. Don't worry too much about it since I can tell when I'm provoking my HCM, and I lay back. I really like my Polar for helping with that.

No trouble raising the heart rate on the BB, though. Might discuss this with my cardiologist when I see him in early Feb.

Dick Melia
Arlington, VA

[Reenie]

Dick, do you have an ICD? A drop in BP is one of the 5 risk factors for sudden cardiac death and you might ought to discuss an ICD with your doctor if you haven't already.

Reenie

[Bettie]

Thank you very much for all of your replies. I have been feeling well this past year after I got the water around the lungs problem solved. I still tend to get tired especially in the afternoons. I do stay active doing my own work around the house along with Curves and aerobics. I'm taking part in all of the church activities and organzations that I belong to.
I now understand it is possible to get the heart rate up above 100 for a short time when on beta blockers. It just seemed kind of contradictory to me to be taking beta blockers at the same time you are trying to get your heart rate up.
When I take my next stress test, what do I need to do to assure that I get my rate up above 100. How many minutes would I need to stay on the tread mill to do this?
Bettie

[mhurley]

It appears that the BB commonly keep the hearbeat near 100 with exercise. I want to ask a question that may seem silly......... Does this mean that we cannot get the same aerobic benefit from exercise as if we got out heart rates up to 140? Does this imply that we need to walk a lot farther than someone who gets their rates up? i.e. walk 4 miles in lieu of 2 miles? Has anyone had input from their doc on this issue?

Mark Hurley

[Pam Alexson]

Mark ,


I have no medical testimony for this but, an HCM heart works harder then most hearts. It has been my experience that when compared to anothers workout ,( a normal cardiac person) my heart although kept to a lower rate by the beta blockers and by me , experiences an equivalent workout compared to a normal person who gets their heart rate up to a higher beat per minute. It appears that it takes less time for us to max out cardiovascular wise/ aerobiclly.

An added thought here is that it is not a positive exercise to force an already hyperdynamic heart that is also thick to work harder then it already does. This pushing does not help the heart become healthier( cardiovascularly) it only can worsen the condition or result in possible detrimental arrythmia. Another words, activity that is consitant and that which exercises the body also exercises the heart is more beneficial over the long haul then no activity at all.

My belief on the HCM heart is that the force with which it contracts not only contributes to its hyperdynamic quality but may in fact be one reason the majority of HCMer's do not also have the comorbid feature of coronary vascular disease.

Your question is a very good one to express to an authority on HCM . The question remains : is the heart rate number key to an appropriate gain for successfull cardiovascular workout?

Perhaps Lisa can help or direct this question for appropriate answer. I too am interested in the fact.

Pam