Athletic Performance and BP Meds

[DaveEM]

Hi Folks, I was wondering if anyone has had similar experiences with athletic performance and BP medication. I had AVR on 10 Dec 2008, and have been jogging (about 11 minute pace from 3-6 miles per run about 3-4 times a week) since mid-February (with Cardio's permission, of course). By now, my running should be back to what it was prior to surgery in terms of comfort and ease of running. I find, however, that my legs get really tired after only about 1.5 to 2 miles, similar to before surgery when I went on a really long run and reached my lactate threshold. My legs feel heavy and it's hard to keep running. I don't believe it's my cardio condition since the times I've taken off from running before (up to 9 months once), I was able to get back in shape easily within a few months.

So, I did some googling, and found that some BP meds can cause problems. I know beta blockers do, but I'm not on any. I'm on Cozaar and the generic for Norvasc (amlodipine besylate). Cozaar is an ACE inhibitor and Norvasc is a calcium channel blocker. Some research suggests that calcium channel blockers can have a negative effect on athletic performance. Ace inhibitors have not shown any problems and I was on Cozaar prior to my surgery and my running was fine then. The new drug for me (since surgery) is the amlodipine besylate.

So, I expect to see my cardiologist again in August for my six month check-up, and I thought I'd mention my theory. I wanted, however, to get your thoughts and experiences first.

Thanks for any insight you can provide.

 

[JeffM]

I'm guessing CCB is the cause

I'm guessing CCB is the cause

Hi David,

I had my AVR in Sept. of '08. My athletic recovery has been delayed due to lumbar surgery in March, but I have resumed training again on the bike for a bit over a month and I am riding pretty hard. My biggest issue is leg weakness and some lingering back pain, but consistent with what you suggested, I don't notice any slowing, weakness or tiring due to the 50mg of Cozaar I'm taking. I did notice a difference in the earlier months when I was on a small dose of Metoprolol. I suspect you are on the CCB for rhythm and HR control. Since it's been over 6 months, I wonder if your cardio would feel it's now safe to wean you off the CCB and see how you do? You can always restart it if necessary. That would give you a chance to see if you notice a difference in your athletic performance. I did just that with my beta blocker and although my resting HR edged up initially, it came back down after a couple weeks. The big difference was I was able to work harder, accelerate faster and get my HR up higher, pretty close to my pre op max, once I got off the beta blocker. One question: is it possible you aren't pushing yourself as hard since your surgery as you did after your previous layoffs?

 

[DaveEM]

One question: is it possible you aren't pushing yourself as hard since your surgery as you did after your previous layoffs?

I thought about that, and I think I'm being honest with myself that I'm pushing pretty hard to run through the wooden legs problem. I've tried to focus on my pace, pushing it when I can, and at times I've been able to get a good pace going for periods of time. I just don't understand why my legs turn weak so soon into my run. My cardio put me on the CCB for my BP which was staying elevated even with Cozaar, so I'm wondering what he'll suggest as a replacement. Sounds like your bike training is going well. I hope I can get back to that kind of training with my running.

 

[JeffM]

I just realized you are in the area. I lived in North Chevy Chase in '88 and '89. I was a runner back then and used to run past the Mormon Temple and out Beach Drive into Bethesda and back regularly. One of my good swimmer friends lives in Kensington. Yeah, unfortunately, you need to keep that BP under control. I'm only on the Cozaar to ease the burden on my heart this first year post op. My BP is in the 110 neighborhood. I don't know where it'll go when I go off the med, but if it gets too close to 120, I'll probably elect to continue it. Have you discussed an alternative med to suuplement the Cozaar that might not have the same impact on your exercise that the CCB seems to have?

 

[DaveEM]

Hi Jeff, I didn't realize we were so close either. I live right by the Mormon Temple and run down Beach Drive (toward Connecticut Ave. and Cedar Lane) regularly. I've not talked to my cardio yet. I see him in August. Lately I've also been wondering if part of the issue is the heat. I'm in Fl. on vacation at the moment and I noticed the wooden legs problem is exacerbated in the heat, both here in Fl. and at home. I'll be sure to talk to him about it, but I do believe it's at least partially related to the BP meds.

 

[tprice54]

You guys need to meet up with us at the Wineglass marathon in October, we can talk about drug issues all day!
The ACE inhibitor will keep your blood vessals open wide, even when you need them to collapse, like when you dehydrate in the heat and loose blood volume,you can get light headed or faint (from experience!). Interesting that your legs are heavy, let us know if your cardio changes your meds....

 

[epstns]

I can't add much, as I'm still pre-surgery, but I can say that when I was put on an angiotensin receptor blocker (Avalide) for hypertension, my exercise tolerance took a drop as soon as by blood pressure did. It hasn't really improved after using the same drug and dosage for 3 years. I'm hoping that my eventual surgery (aortic valve replacement) will help me back to at least an enjoyable pace.

 

[DaveEM]

While I was on vacation (just got home yesterday), it occurred to me that I've been running in 92 degree Florida temps on the beach on allegedly hard sand. I was doing an out and back, and faced the strong beach wind on the way back. Sooo, I'm now wondering if the heavy legs (at least recently) can partially be explained by the heat and terrain. That doesn't quite explain, however, why my legs feel heavy back here at home on normal runs. I have to say, though, that the heavy legs is only "most" of the time. I've had a few good runs where I could go the distance fairly easily (even up to 5.5 miles). I think I noticed that the good runs were in fairly cool weather, so maybe it's all about the heat. Anyone have particularly difficult times running (or exercising; biking, etc) in the heat? In the past the heat would slow me down, but I wouldn't necessarily get heavy legs as often as I do now.