New Here - Are Beta Blockers necessary?

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Snwbrd031

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Dec 21, 2021
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5
Hi! I’m so happy to have found a forum like this. I am 35 years old and was diagnosed with an Enlarged Aortic Root when I was in my 20s. And I believe bicuspid. At the time it was 4.0cm and they just told me to ignore it. A few years ago I started to get screened again and now I’m at 4.1cm - so very happily not much growth in 13 years.
Despite this my cardiologist recommends that I take a beta blocker Toprol XL (I suppose for the rest of my life). My blood pressure is normal (last check was 116/70) and I don’t have any obvious symptoms so I am very hesitant to take beta blockers forever. Does anybody here have any opinions on this?
 

AZATADINE

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Aug 30, 2021
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I had my aortic valve replacement 7 weeks ago and I was put on Bisoprolol 2.5mg once daily post op. I never had high blood pressure to start with but my blood pressure was quite low on that dose (100/75 or thereabouts) and I found that I'd have a moment of slight light headedness if I stood up quickly occasionally.

At my 6 week check up, my surgeon reduced the dose to 1.25 mg once daily but indicated that I'll likely be on this for life (or at least for a long time). My blood pressure is closer to where it should be on the lower dose now.

Not in love with having to take it for life either if I'm being honest. Probably a follow up item to discuss with my cardiologist when I'm recovered but I'd say I'll be on it for a couple of years anyway.

I'm new to all this too though so I'm sure some of the more experienced folks will have better info
 

Superman

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Grand Rapids, MI, USA
Welcome to the forum! Stinks that you find yourself here, but new views are always appreciated.

Regarding your question. I was put on a beta-blocker after my last surgery (aneurysm repair). Been on it for 11 years now. Mostly I don’t notice it. My BP was never an issue and still isn’t. Just tested at 117/79. Not sure what it would be unmedicated.

The only negative I ever experienced was if I exercise too soon after a dose, it can be difficult to get a good workout because my heart rate won’t come up. Normally I take my morning dose around 7:00 and get my workout in around lunch. That works okay. Or if I do a morning workout, I make sure to wait until after the workout to take it.
 

Snwbrd031

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Dec 21, 2021
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Congrats on getting through with the surgery! I’m sure you’re happy to be on the other side.

As of nowmy thought is to not take beta blockers and check the size again in a year. I want to know if it’s possible to stay the same size without taking them.
 

Brokenhip

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May 20, 2019
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Melbourne, Australia
Suggest you try without them. My experience:
1. Put on beta blockers for a couple of months prior to OHS for AVR after aortic regurgitation went to severe. Continued to cycle but found max heart rate 100BPM, was normally about 140. Very frustrating.
2. After OHS, no meds except for baby aspirin & heart rate pretty much back to normal.
3. Approx. 2.5 yrs later had an episode of AFib which was controlled with a beta blocker (Sotolol). Plan from the cardiologist was to stay on it, but again cycling could not get HR above 95. So after much discussion with the cardiologist & my GP the decision was to stop the Sotolol & monitor, so far after 15 months no problems.
Without my insistence to try without, I would still be taking a medication for no apparent reason.

While your situation is a little different to mine, I believe questioning in depth the need to use it is very worthwhile.
Good luck going forward.
 

Snwbrd031

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Dec 21, 2021
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Thank you very much for the advice - sounds like it can be really frustrating to have that ceiling on exercise.
 

Protimenow

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California
I went for a few years without a beta blocker. Last year, I had tremendous issues with multiple simultaneous arrhythmias.

I had negative side effects to most beta blockers.

I now have a pacemaker that keeps my heart rate above 70 most of the time, and might (I'm not sure) help to correct a heart rate that's too high.


I've been taking a calcium channel blocker - Verapamil for more than a year - I think it was for blood pressure.

My new cardiologist gave me a beta blocker - not to reduce my blood pressure - but to even out my heart rhythm (I was having frequent SVTs). So far, it's working.

I think I'm doing better now that I take the beta blocker.
 

cldlhd

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Apr 9, 2014
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Levittown ,Pa 19054
Hi! I’m so happy to have found a forum like this. I am 35 years old and was diagnosed with an Enlarged Aortic Root when I was in my 20s. And I believe bicuspid. At the time it was 4.0cm and they just told me to ignore it. A few years ago I started to get screened again and now I’m at 4.1cm - so very happily not much growth in 13 years.
Despite this my cardiologist recommends that I take a beta blocker Toprol XL (I suppose for the rest of my life). My blood pressure is normal (last check was 116/70) and I don’t have any obvious symptoms so I am very hesitant to take beta blockers forever. Does anybody here have any opinions on this?
It's going to be hard for anyone out here to give her expert medical opinion. But I think cardiologist err on the side of caution regarding this. I had my aortic root, sending aorta and hemi yards replaced back in 2015 as mine was 4.9 cm at the time. I only knew about it for 11 months before surgery so I didn't have to deal with it long. But my cardiologist wanted me on beta blockers as well. Even though my blood pressure was good. The thought was that I could have spikes such as arguing with a co-worker, spouse, someone cut you off on the highway, etc. And apparently they would level I could have spikes such as arguing with a co-worker, spouse, someone cut you off on the highway, etc. I didn't like them as my blood pressure would get pretty low while on them, but after surgery I was off of them. I know that doesn't help you much with your question but my surgeon had a different opinion to whether or not I needed them. Wish I guess is pretty common in the medical community.
 

cldlhd

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Welcome to the forum! Stinks that you find yourself here, but new views are always appreciated.

Regarding your question. I was put on a beta-blocker after my last surgery (aneurysm repair). Been on it for 11 years now. Mostly I don’t notice it. My BP was never an issue and still isn’t. Just tested at 117/79. Not sure what it would be unmedicated.

The only negative I ever experienced was if I exercise too soon after a dose, it can be difficult to get a good workout because my heart rate won’t come up. Normally I take my morning dose around 7:00 and get my workout in around lunch. That works okay. Or if I do a morning workout, I make sure to wait until after the workout to take it.
I wonder if it's just different doctors with different ways of doing things. But if your blood pressure was fine and your aneurysm is repaired I wonder why they still want you on them?
 

Keithl

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Joined
Apr 20, 2019
Messages
513
Hi! I’m so happy to have found a forum like this. I am 35 years old and was diagnosed with an Enlarged Aortic Root when I was in my 20s. And I believe bicuspid. At the time it was 4.0cm and they just told me to ignore it. A few years ago I started to get screened again and now I’m at 4.1cm - so very happily not much growth in 13 years.
Despite this my cardiologist recommends that I take a beta blocker Toprol XL (I suppose for the rest of my life). My blood pressure is normal (last check was 116/70) and I don’t have any obvious symptoms so I am very hesitant to take beta blockers forever. Does anybody here have any opinions on this?
With an enlarged aorta keeping your pressure under control is vital. IMO and YMMV the key differences are “Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline.” Thus the sudden jolt to raise your heart rate and thus pressure. Other BP meds work differently but relaxing the vessels walls and other ways. Othe BP meds will not restrict your heart rate from increasing. I was on losartan for years and then beta block after surgery. I tolerated both very well with no negative side effects. I did go back to losartan after about 18 months as I prefer how it works and potentially better overall improvement. “Losartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, losartan relaxes the blood vessels. A lower blood pressure will increase the supply of the blood and oxygen to the heart.”

My recommendation is do your research and make sure you have a conversation with your cardiologist to review your options, the pros and cons or each and then you decide what is best for you. Also do not hesitate to,chat with your primary doctor or get second opinion. I had a cardio that is highly respected in ATL and after a while of his ego and him not liking me being engaged I found a cardiologist that is my open to conversation and working with me. I have another post somewhere her about how upset my old cardio was when I went to Cleveland and got a mechanical valve vs. his do it in ATL and use tissue valve.

in the end it is your body and your choice, get well informed and feel good about whatever course of action you and your DR select.
 

pekster11

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Apr 20, 2011
Messages
225
Location
Chester, UK
I had aortic valve and aorta aneurysm repair in April.
After I was discharged I wasn't prescribed any beta blockers
About 10 days after being discharged my heart went into atrial flutter
Had to spend a night in A&E, and a further 3 days in hospital
After that i was prescribed 10mg bisoprolol and was cardioverted back into regular heart rhythm 2 months later.
Gradually I've had the dosage of bisoprolol reduced as I have a low resting heart rate anyway (around 45 bpm). Currently on 2.5mg day
At my last outpatient appointment at the hospital the cardiologist agreed with me to come off beta blockers completely

Incidentally, today is the last day I will be taking beta blockers
 

Keithl

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Apr 20, 2019
Messages
513
After surgery I think beta blockers are the norm as the heart recovers to prevent any stress on the heart, which is why I stayed on them for some time.
 

Chuck C

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Dec 5, 2020
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1,304
Welcome to the forum!

I was never on BP meds before my surgery but was put on Metoprolol, a beta blocker, after surgery. I believe this is the standard of care, to keep the blood pressure low as the sutures heal. As others have shared, I did not like the way it affected my exercise, as it kept my heart rate low. After 2 months I asked my cardiologist if I could go off it, and see if my BP stays low, like it was prior to surgery. He agreed. My blood pressure stayed low, so I have stayed off it, with his approval.

I would suggest having the conversation with your cardiologist. I think that if I did not bring it up that he would still have me on the beta blocker. These things can be overlooked. Your situation is different from mine, however, in that he is trying to keep your BP low to slow or stop the growth of your aneurysm.
 

Snwbrd031

Member
Joined
Dec 21, 2021
Messages
5
This has all been very helpful and informative. Hearing people individual stories really helps me shape my own opinion. It sounds like everyone takes BB immediately after their surgery but not everyone is on them before or for long term after. I will talk to my PCP about what to do but I think waiting a year and reassessing is the thing to do at the moment.
 

pearjas

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Aug 30, 2015
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Location
Missouri
Hi there! I just noticed your post and I would agree with your thoughts in the last post. I go to KU Cardiology and while I've been on a beta blocker, they said I could stop it as I was "stable". Like you, I was right at 3.9-4.0 but I was in my early 30's when it was detected. I'm 38 now. My doctor feels a beta blocker isn't necessary unless 1) I have symptoms along with the dilation, such as POTS or 2) There's an increase in size. I did have an increase in size in 2018, but a beta blocker was not added. I suspect one would have been added if i would have had another year where it increased, but it's been stable.

This is something I've done a lot of personal research about and you do read a lot of conflicting information. It's good that you are trying to be as informed as possible!
 

Snwbrd031

Member
Joined
Dec 21, 2021
Messages
5
Hi there! I just noticed your post and I would agree with your thoughts in the last post. I go to KU Cardiology and while I've been on a beta blocker, they said I could stop it as I was "stable". Like you, I was right at 3.9-4.0 but I was in my early 30's when it was detected. I'm 38 now. My doctor feels a beta blocker isn't necessary unless 1) I have symptoms along with the dilation, such as POTS or 2) There's an increase in size. I did have an increase in size in 2018, but a beta blocker was not added. I suspect one would have been added if i would have had another year where it increased, but it's been stable.

This is something I've done a lot of personal research about and you do read a lot of conflicting information. It's good that you are trying to be as informed as possible!
Sounds like you’re just like me. So you’re off beta blockers now and it pretty much stayed the same size?
 

Mister_James

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Aug 24, 2013
Messages
126
Location
NYC
Messing with anything close to the heart can easily trigger arrhythmia. Beta blockers are very good at keeping the heart rate lower.

Also an aneurysm means you have high pressure in your vessels. You do not want to enlarge anything else.

As for getting your heart rate up, you work from you resting heart beat. If beta blockers dropped you 10 beats per minute, adjust your heart rate down by 10.

Feeling faint when you stand quickly is a normal side effect of the pills. They may also mask effects of low blood sugar for diabetics. Otherwise my doc says if you are getting erections, what's the problem?
 

Paleowoman

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I was given beta blockers post surgery. At three weeks the dosage was halved and then stopped completely at six weeks.

@Snwbrd031 - I see you're not asking about post surgery beta blockers - if you're concerned about being prescribed beta blockers now can you get a second opiniom ? Or have you got a blood pressure monitor ? If so perhaps ask the doctor if you could lower the dose of beta blocker leading to a trial with out it ? My blood pressure is always high in any medical situation, even with the nicest doctor, so it's sometimes suggested I should be prescribed something for my blood pressure. instead I now monitor my blood pressure myself for at least two weeks before any cardiology appointment (with upper arm cuff monitor same as hospital's), I take it several times a day and record it all and print out the results for the cardiologist so he can see what my 'normal' blood pressure is. I also sometimes bring my blood pressure monitor to the appointment and the doctor takes my blood pressure with both his monitor and mine to check the accuracy of mine - it is accurate and always as high as the doctor's monitor in the hospital !
 
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