Exercise and Heart Meds

[cday]

What are your experiences with exercise and heart medications? Have you switched meds to allow more exercise?

My husband has tried two beta blocks, neither of which seems to be acceptable. The meds are restricting his tennis playing. Thanks to this board and some very helpful people we know it will probably take a year to return to his previous level.

First med: metoprolol - feeling faint upon standing and slight cough (tennis playing OK)

New med: carvedilol - edema and lactic acid buildup with exercise (his heart rate wouldn't get over 100) - (tennis playing exhausting)

It seems that most people on this thread are runners, but I'm sure that the same issues would apply to tennis.

What has worked for you?

 

[SumoRunner]

I've been on metoprolol for about 20 years, but at a rather low dose, 25mg. It has never made me weak or feint but it does slow down my running a bit because it trims the max HR. On a normal training run what does it matter? I'm in no hurry to go anywhere. For a race it can make a difference of 10-15 seconds per mile, certainly not minutes per mile.

I normally take it at night before bed, so for the last 5K I ran I skipped it the night before and waited to take it until after the race. That's enough to allow my HR to go higher for a better race pace and it's not like I actually go "off" the med. for a significant time. It's just postponed for half a day. I've been doing this for a long time.

On another recent thread here, some of us compared times from prior to AVR and after. I have a 30 year history so have lots of data points. We found that when adjusted for age, the valve is costing us something less than 1 minute per mile. The effect of the beta blocker drug is only a part of that.

 

[cday]

I normally take it at night before bed, so for the last 5K I ran I skipped it the night before and waited to take it until after the race. That's enough to allow my HR to go higher for a better race pace and it's not like I actually go "off" the med. for a significant time. It's just postponed for half a day. I've been doing this for a long time.

Thanks for the trick. He can discuss this option with his cardio. It might be he can practice on meds, but "skip" or be late when he has a match.

 

[SumoRunner]

Thanks for the trick. He can discuss this option with his cardio.

I'll tell you right now his cardio won't like the idea. It's like telling the wife you're going to cheat on her just a little bit, but only when you're really, really horny. Many of us who have been in the game for a long time still take such liberties. Not the fidelity thing, the meds thing I mean.

 

[Alex]

Tennis and beta-blockers

Tennis and beta-blockers

Hi,

I am also a tennis player, I was very competitive prior to surgery. I am 37 and I had Aortic Valve Repair 8 months ago. I can bike decently and running is OK too ( not like before surgery though) but tennis is very exhausting and that is driving me crazy. Even though I am on carvedilol ( now they have increased the dose to 18.75 mg twice a day) my heart rate still goes up too much while playing tennis and I can hit more than a few shots before my heart gets to over 160 and I start not feeling well, getting PVCs, tachycardias and I even got an episode of A-fib. This doesnt happen biking or running. I love tennis and I just can't play. The weird thing is also that at five months after surgery I seemed to handle tennis better, I didnt get so tired, I dont know if my heart is getting worse or this medicine has stopped working, or I need a different med or maybe I dont need it or what...

If anyone is a tennis player or has any similar experiences with other sports please share... it is much harder for me to live without my passion, I should be happy for being alive, maybe I am spoiled but I need to play again !

Thanks in advanced for any info you can share...

 

[ALCapshaw2]

Thanks for the trick. He can discuss this option with his cardio. It might be he can practice on meds, but "skip" or be late when he has a match.

Have you husband ask his Cardio about reducing his dose also.

When I complained about feeling 'dragged out' while on a Beta Blocker, my cardio had me cut my dose in half for 2 weeks. BIG IMPROVEMENT in energy and it still 'did the job'. Ended up cutting it in half again as my final dose which worked for a couple of years until other changes developed.

 

[perrypiratesdad]

I've been on metoprolol for about 20 years, but at a rather low dose, 25mg. It has never made me weak or feint but it does slow down my running a bit because it trims the max HR.

On your normal dose of 25mg, what can you get your HR up to without feeling ill? Mine would only go up to about 120 bpm and that was at a fast walking pace.

 

[SumoRunner]

On your normal dose of 25mg, what can you get your HR up to without feeling ill? Mine would only go up to about 120 bpm and that was at a fast walking pace.

No idea. I don't own a HRM but once last winter I checked it while running on a treadmill, not running all that hard either, and it was at 156. Can't say that I trust that thing to be very accurate though. I'm 60 yrs old so my drug free max ought to be about 160.

I have been running for 35 years so I learned decades ago to train by feel and never knew my true max. I only measured my resting HR which was about ~53 25 years ago and 55-57 now, so the low end hasn't changed much at all.

I did 10-12 weeks of interval workouts this past spring busting it pretty hard. Then I ran a track mile in June, balls to the wall in 8:23. Adjusting for age that would be 6:45 for a younger man. I didn't stop the metropolol for training but did for the mile race and another 5K that I ran in July in 28:58 (9:20 per mile) which was the fastest I've run in several years. I held nothing back so I'll bet whatever my max is, I hit it that day.

Mind you, I'm 17 years from the AVR, so any effects from the surgery itself are long since gone and my system has fully adjusted to the drugs. My primary limiting factors are weight and age now. All the pushing and racing aside, my greatest joy is an easy 10 mile run along the river on a Saturday morning where I can simply lose myself in the moment. The HR then does not matter a whit.

 

[perrypiratesdad]

No idea. I don't own a HRM but once last winter I checked it while running on a treadmill, not running all that hard either, and it was at 156. Can't say that I trust that thing to be very accurate though. I'm 60 yrs old so my drug free max ought to be about 160.

That's pretty good for an old F*A*R*T!

I had to ask my cardio to take me off the Beta blocker so I could exercise. They had me on 100mg/day, so I was really limited while on it. I have had no ill effects while off other than a few bouts of "clipity-clop" heart, but that normally passes fairly quickly.

 

[SumoRunner]

They had me on 100mg/day, so I was really limited while on it. I have had no ill effects while off other than a few bouts of "clipity-clop" heart, but that normally passes fairly quickly.

Wow! 100 is extreme. I started out on 50 but took that down to 25 within months and he's kept me at that since. My irregular beats are almost entirely caused by caffeine. I decaffed myself years ago, but from time to time I still love a good cup-a-joe. Decaf coffee tastes like warm sewage but I can't tolerate the high octane stuff much more often than once a week. There are a few other things that will cause them, stimulants mostly, but exercise isn't usually one of them unless I way over-do it, like running 12-14 miles or racing a 15K. I never do marathons.

 

[jds]

See if you can switch to a non-beta blocker

See if you can switch to a non-beta blocker

I was on a fairly low dose (25mg) of metoprolol and concerned about its effect on maxHR. I talked to my primary care doc and he just switched me to an ACE inhibitor (lysinopril).

He said that in my case, the effect (3 months post surgery) was really as an anti-hypertensive more than anything else.

If your doctor is mainly trying to control BP, talk with him/her about different therapeutic classes. I know of beta blockers, ACE inhbitors, and calcium channel blockers. There are probably others.

But each class does a slightly different thing so your doc might have a particular reason for a beta blocker.

John

 

[spartangator]

Not that a sample of one is the best indicator, but I had similar issues with exercise when taking metoprolol. A few weeks back, I switched to Coreg (which is a different type of med, of course) and have found fatigue issues much reduced.

I'm sure that time and healing have played a role, too, but the med switch has been nice so far. I feel better all around and have a little more gas in the tank when running or lifting weights.

In response to the heartrate question from perrypiratesdad ...mine gets up there, and I feel fine when it does. Quite tired, of course, but no illness.

I wear a monitor when working out, and during heavier exertion, it'll go into the 170s-180s briefly. I'm not advocating that by any stretch, though (I don't mean to get it that high). It is just below the max for my age group so the cardiac therapy people said not to worry about it. Just don't make a habit of it.

It sounds like you've had some productive conversations with your cardio already. Hopefully over time as you and your doc sort out your med situation, your heart's ability to deal with exercise will change quite a bit, too. All the best.

 

[cday]

Thanks for everyone's help. I wanted to update the thread: Exercise is tolerated again -- Chris' dosage of carvedilol (Coreg) was lowered to 6.25 mg once a day and that has seemed to resolve his issues -- which we now believe were all caused by the edema (at least 8 lbs worth). Now he sees great value in weighing himself first thing every morning since that could have alerted us to the edema right away.

 

[Alex]

Cday,

Does your husband take the regular carvedilol/coreg 6.25 mg or is it in some kind of extended release form ? If is is the regular one, what time seems to work best for him to take it ?

 

[cday]

Alex,

Chris takes a generic regular dose (not extended release).

He takes it at breakfast. During the week he only plays tennis at night, and I don't think he has played in the AM since the reduction in meds, but he has gone to rehab and feels much better during exercise there.

Cindy

 

[cday]

Alex,

A doc friend says that taking the once a day meds at bedtime might be an even better idea for tennis stamina -- if the cardio will OK that.

Cindy

 

[Alex]

Cday,

Thanks a lot, when you say "once a day" you mean the extended release ? or you are still talking about the regular ones ? A extended release should not really matter what time you take it.

The last few times I have tried to play I was feeling OK ( not tired) but I have to stop playing because of arrtyhmias, too many PVCs and then I get tachycardia...I dont undertstand anything...my problem seems to be just with tennis...

Thanks,

 

[cday]

Cday,

Thanks a lot, when you say "once a day" you mean the extended release ? or you are still talking about the regular ones ?

Regular kind.

Sorry to hear about your continuing problems.