Blood Pressure Medications and Heart Rate Zones

author : AMSSM

comments : 3

Some blood pressure medications will not allow you to get your heart-rate up into the proper exercise zones. Learn why and what you can do about it.

Question

"I take blood pressure medications every morning and it is really hard for me to get my heart rate up during training. Is this a bad thing or a good thing? I'm looking for positives or negatives and ways to improve."

Answer by Grant Morrison, MD
Member AMSSM

First of all, credit to you for exercising with high blood pressure! Exercise can significantly impact high blood pressure, both through weight loss and metabolic changes. However, your blood pressure medicine may be limiting your exercise as well. Thanks for providing the additional information that you take Metoprolol. Metoprolol belongs to a class of medications known as "beta blockers".  These medications are extremely valuable especially for what the American College of Cardiology calls "compelling indications: heart failure, heart disease, kidney failure, diabetes and stroke prevention."  If you have one of these conditions, then Metoprolol is an excellent choice. However, the American College of Sports Medicine warns that "beta blockers can substantially alter sub maximal and maximal exercise capacity."What does that mean? It means exactly what you are struggling with! One of the benefits of beta blockers is that it prevents the heart from working too hard, so that it cannot pump too fast. Sound familiar? 

So, ask your doctor if it is safe for you to be on another medication. My favorite in an exerciser is something from the class of medications known as "ACE inhibitors". Examples include Lisinopril, Enalapril, or Ramipril. They have their own compelling indications, and their own adverse effects (a strange cough, high potassium levels in the blood, and occasional allergic reactions, to name a few). But they do not limit heart rate or function, and often can improve it. So, if your own "compelling indications" make this a good option for you, see if you can make the switch!

Other things to watch out for while training on blood pressure medications include metabolic abnormalities such as high or low sodium and potassium.  Overall hydration issues can be a concern as well, particularly if you take a a medication that works by reducing fluid in the body ("diuretics") such as Hydrochlorothiazide or Chlorthalidone. Make sure you do your homework and listen carefully and ask questions when a physician recommends a blood pressure medication for you.  

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date: March 15, 2012