Running whilst taking beta-blockers


Hi,

I originally posted this in the health forum yesterday but got no response. It's now dropped to the bottom of the second page so I decided to give it one last try here:

Has anyone had any experience of running whilst taking beta-blockers?

I started running around mid April and am currently in training for the Great North Run and all’s been well so far with modest but satisfying progress.

However, I’ve recently noticed some strange patterns in my performance and I’m wondering if they could be to do with the beta-blockers that my GP prescribed for hypertension.

I’ve noticed that sometimes, my long run - 8 miles this week - feels great and I could carry on for miles. Other times the same distance (or even less!) feels like hell.

Until recently, I decided that it was ‘just one of those things’. That is, until I started wearing my HRM. I got the HRM years ago when I used to do a lot of cycling but I hadn’t worn it for running until a few weeks ago.

The pattern I’ve noticed is that on a long run, if my HR gets up to around 130-140 BPM, everything’s great and I feel like I could run forever.

On the runs when I feel like hell, my HR maxes out at around 110 BPM and I before long, my legs feel like lead, my lungs burn and I just have to walk.

This was particularly pronounced on my 8 mile run today. About 10 minutes before leaving for my run, I took a beta-blocker. For the first 3 miles at 10 minute mileing, my HR was 130-ish. After that, without any reduction in pace, it dropped until it stabilised at around 110 BPM. After 5 miles, increasingly tired, I had to do the rest of the session as a run/walk.

Within a minute of stopping, my HR was down to 97.

My theory is that on the days when I feel good, I’ve run early and therefore haven’t taken the beta-blocker until after the run. I’m tempted to experiment with not taking the beta-blocker until after I’ve run. Has anyone any ideas ?

BTW, I asked my GP if it's OK for me to run and swim and she said it is - however, she's not really a 'fan' of competetive activity in general.

Regards,

Mikey
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Comments

  • Mikey - I saw your post yesterday but had no idea of any answer. It's obviously important that someone responds who knows what they're talking about - it doesn't always matter on some threads :-)

    Velociraptor (V-Rap) is the usual forum guru on health matters - if she doesn't notice the thread this time you could mail direct.

    I'm interested in any answer you may get since my own GP was threatening me with beta-blockers a while back. Since then I've been training hard to get my blood pressure down so I won't need them, so far successfully. Next check is Monday and if I am still in the normal range I think I'll be off the hook.

    Take care
    Glenn
  • Glenn,

    many thanks for the reply.

    Unfortunately, when I was offered the medication, I (stupidly) didn't take your course of action i.e. exercise.
    At least not until April when I started running in order to try to get off them.

    So if my pet theory is correct, one of my main concerns is that the medication could be limiting the effort I'm able to apply to getting off them.

    For the moment at least, I intend to experiment with systematically taking the pill later.

    Good luck Monday and thanks again,

    Mike
  • Hi, having spoken to a BACR qualified fitness instructor, your problem could be the Beta Blocker doing it's job of supressing your heart rate but it could also be likely that your heart is not responding to the exercise properly and is in distress(sorry to sound so negative).Either way experimenting is not the way to go. You should get checked out ASAP. And get an exercise program suitable for you from an instructor qualified in that field.
  • Sorry should have explained BACR stands for British Association of Cardiac Rehab which not only with the after effects of heart ilness but in the prevention of it.
    Good Luck with your helth and your training.
  • Andrew,

    Thanks for the reply and I do take your point (more of this later).

    However, I rose early today and went for another 8-miler *before* I read your response. I didn't take the pill beforehand with the result that I did the run at 10 minutes per mile pace and felt I could have done more.

    My HR rose smoothly to 130 BPM over the first 2 miles or so, then gradually up to 135 BPM from mile 2 to mile 7.
    I put in a little more effort on the last mile and then the HR rose to 141.

    Although my earlier observations regarding HR and beta-blockers were made with little more than anecdotal evidence, I have to feel that today's result lends *some* credence to my theory. Having said that, it's only one data-point and as your BACR contact has implied, it would be unwise to collect too many more data-points before getting checked out :-(

    Although my efforts to locate a nearby BACR instructor have so far drawn a blank, as a starting point I've set up an appointment with my GP. This will give me a chance to discuss my ideas and aspirations more frankly than I have to date.

    Once again, many thanks for taking the time to look into this.

    Mikey

  • Andrew,

    PS - my appointmemt is for tomorrow, and, yes, I will still be investigating the BACR route.

    Cheers,

    Mikey
  • Mikey, apologies for taking so long to get round to picking up this thread.

    I am mightily impressed that you are managing to run so well, and mount a reasonable heart rate response to exercise, while taking beta-blockers. You must be made of high-quality protoplasm.

    All the same, I would choose another type of medication if I were prescribing for an athlete with hypertension. If you are ONLY on the beta-blocker for hypertension, and don't have angina, it would be worth explaining the situation to your GP and asking for an alternative. There are about 10 different classes of drug for hypertension, and good choices for you would be:
    ACE inhibitors (ending in -pril).
    Angiotensin-2 antagonists (refined ACE inhibitors, ending in -sartan).
    Alpha-blockers (Doxazosin is the most commonly used).
    Calcium-channel blockers (ending in -dipine). Can cause headache, flushing and ankle swelling in some people, though.

    Diuretics might not be an ideal choice for obvious reasons, and Moxonidine (Physiotens) is a bit sedating. Everything else is very small print.

    You're taking the right approach. Aerobic exercise, a diet low in processed food and high in fruit, vegetables and grains, and weight loss if you're overweight, are all good for lowering blood pressure - at least as good as pills! So you may find that you'll be able to stop treatment completely as your training progresses.

    You've made my day, Mikey (as Glenn did earlier in the Fat Forum, when he prompted me to get over here and talk to you). My heart absolutely sings when someone takes the "lifestyle" bit between their teeth rather than passively opting for pills. Which is sad, because it is a sign of how rarely it happens.

    Hope that helps a little.

    Cheers, V-rap.
  • Glenn,

    Many thanks for pointing V-Rap this way. It’s a great help to get input from others who share similar goals

    V-Rap,

    I really appreciate your positive thoughts. I’ve got so much into the running now, it fuels my motivation to lead a healthier lifestyle all round. Needless to say, I don’t want the beta-blockers to get in the way of this.

    When hypertension was originally diagnosed, it didn’t half hit my self-image and although I always intended to try to get myself of the pills, it was a case of ‘Ok, I’d better take up exercise…I’ll start next week’. Of course next week never arrived and my lifestyle didn’t improve much either. That is until earlier this year.

    An interesting side effect of the running is that originally, I viewed having to regularly take tablets as merely a nuisance (and un-cool). However, now I can see the effect that they also have on my running performance, you can guess just how motivated I am to find ways to get myself off them.

    So, one of my main goals for tomorrow’s appointment is to discuss alternative treatments. Thanks for the suggestions – I’ll print the list and take it with me tomorrow.

    Thanks again.

    Mikey

  • I had a similar problem a while ago.
    I have kidney failure and require haemodialysis three times a week - as your kidneys control your BP... no kidneys, BP out of control (mine reached 269/158).
    For a while I was taking a cocktail of - nifedipine, doxazazine, amlodipine, atenolol and ramipril. Once it was under control, I was cut down to only three types of pill.
    Then I started running again, very quickly I was down to just 50mg atenolol a day. I have read research (american) that shows that even gentle exercise can reduce BP medication by up to 40%.
    The problem was that the mix of atenolol and running made my BP very volatile - it would go up and down like a yo-yo, in my condition that is very undesirable. My nephrologist stopped the atenolol and put me on perendopril (ACE inhibitor) - all the problems went away. Now I only take 2mg four days a week, and we are considering stopping it altogether for a trial period.
    Many quacks now agree that ACE inhibitors are much better for your heart than other types of medication. If your's is reluctant to change your pills - get a new quack!
    Incidentally - next year I shall be running the london marathon for the National Kidney Research Fund, as far as anybody knows I shall be the first haemodialysis patient to attempt this.
    best wishes
    RoboKidney

  • RoboKidney,

    Dialysis! – and to think that I’ve sometimes felt I had excuses not to go out and run. I never cease to be impressed by what people achieve :-)

    Speaking of GPs, I’ve never really been a frequent visitor to ours. However, one thing I do know is that our original GP is not keen on running - sort of: “If you feel the urge to go out and run, lie down until it passes”.

    However, the practice recently gained a new practitioner and I first/last saw her in June. I told her I was running, cycling and swimming and asked if she thought that this was Ok. Her response was that if it felt good, then I should keep it up.

    I specifically requested to see her today and I intend to discuss my observations and experiences regarding fitness/hypertension and my desire to eventually kick the tablets. Considering her more positive approach, I'm optimistic that we'll achieve something.

    So, thanks for your inspiring post and best of luck in your FLM run - keep us in touch with your progress.

    Cheers,

    Mikey

  • Robokidney, that's brilliant. I trust you're going for the full whack of publicity! E-mail me with your details if you'd like to add me to your sponsor form.

    Cheers, V-rap.

  • RoboKidnet,

    Good thinking by V-Rap - mail me with sponsorship details too.

    Cheers,

    Mikey

  • A quick update:

    I saw my GP and she's switched my medication to a Calcium Channel blocker so I'm hoping that this will do the trick as regards HR.

    However, she doesn't want me to drop the beta blockers overnight - rather, she'd like me to come off them gradually over the next 14 days. I can handle that. I'll do my little trick of taking them after the run.

    All in all, I guess it'll be a few weeks before I'll be totally clear of the BBs.

    So, it's now back to the grind, trying to free myself of the need to take any of these infernal pills :-)

    For anyone interested, I'll report back any findings.

    Cheers,

    Mikey
  • Please do, Mikey. Reducing gradually is sensible, although probably not strictly necessary if you're on them for hypertension and within the licensed dose range.

    Keep on running. Getting off the pills must be a huge incentive to face the road on those days when no other inspiration is available.

  • Robokidney- yes, put me on your list too for sponsoring for FLM.

    And keep us informed of your training. The "if she/he can what's my excuse" reasoning is extremely useful in keeping some of us on the roads.

    Marj

  • Thank you for your words of support.
    I do have a website about my marathon attempt - but it is offline for a few days as the host company has had a denial of service attack and has taken some servers offline while they sort things out. When it is running again I will e-mail all of you with the address, and I will try to post the address in an active thread.
    Yes, we are going for full publicity (or at least the National Kidney Research Fund is - they are thrilled skinny at the prospect of a real live dialysis patient running the marathon). They are talking of using my story in an advert in the FLM magasine that goes out with the acceptance notes - to hopefully inspire a few non-commited runners to sign up. There are one or two other ideas being discussed - they want to make the most of it because the marathon has captured the public imagination, and charities thrive on publicity.
    I wish I was not the first dialysis patient to try the marathon, as there is no-one that I can go to for advice - the 'standard' advice on nutrition, hydration, and so on would be very dangerous for me to follow, so I am having to make it up as I go along - which is a bit scary.
    The big problem at the minute is hypoglycaemia in the afternoon, which doesnt seem to respond to the usual treatments. It takes about 24 hours for the body to recover from dialysis so I dialyse 3 days a week and take 3 days to recover (with sunday off!), so I'm either dialysing or recovering from dialysis - the extra strain of training does not help things. With the help of my dietician, doctors and nurses we are trying to devize a strategy that will get me through - but as nobody has done this before, nobody knows what will work in my particular situation.
    best wishes
    RoboKidney
  • Hi Robokidney.

    I ran London this year alongside a man who had a metal rod in place of one of his lower legs, and only discovered afterwards that he had a full artificial leg on the other side and had had part of each arm amputated. For him to do a marathon was some achievement, but for you it's going to be a million times bigger.

    If you've got the whole team in your corner, I've no doubt that you can do it.

    Cheers, V-rap.
  • Bloooy hell!
    Im really impressed with you Robokidney
    Im a dialysis doctor
    Sorry ,no helpful tips cos this os new to me too
    But can i pick your brains later in case one of my patients has the same idea!!
    Its usually only transplant patients!!
    Ill be watching this space and if i get any useful info will post
    Good luck
  • Hi Mikey
    I have an angina problem and have to take Atenolol, benzafloride and coversyl plu half aspirin every day. My regime is that i do it first thing in morning whatever so always about 40 minutes before run. Find that Hr stays around 110-130 on this basis.My RHR is about 45.

    I wish I had a GP like V rap with an interest in running.

    robokidney put me down on your sponsor sheet for a tenner.
  • Ps im assuming you cant do CAPD ???

  • Head Gone,

    Thanks for the info.

    My problem seems to be that if I take the BB early, I can't get my HR *above* 110 BPM. How does your run feel at 110 BPM?

    Anyway, I collected another data point yesterday. I did my long run (9.3 miles, 93 minutes), again only taking the beta -blocker once I finished my run. I then took the BB once I got home. It felt good again and my HR was 130-135.

    So I guess we're all a bit different.

    Cheers,

    Mikey

  • Glenn,

    good luck with your BP check today :-)

    Cheers,

    Mikey
  • The thought of running a marathon with a bellyful of CAPD fluid sounds thoroughly uncomfortable, but I suppose it's better than pushing a dialysis machine.

    Glad benz brought the transplant thing up - my first instinctive response was "have a transplant now, and you'll be just about recovered from the op in time to start training for the marathon at the turn of the year". But it's not that easy.

    I suppose it's going to mean a lot of checking of blood and trying to get an accurate estimate of your fluid and electrolyte losses in sweat and breath during heavy prolonged exercise before planning your marahon regime. Or doing the entire marathon at walking pace with a few medical checks along the way (and no reason why you shouldn't - you still wouldn't be last and you'd get the biggest cheer anyway).

    Cheers, V-rap (who knows practically zip about dialysis, although I once worked with a nurse who had had a transplant and used his old dialysis fistula as a chat-up line - "Wanna feel my vibrator?")
  • Mikey

    Thanks for the thought. It was 130/86 and they're on the verge of throwing me out as a timewasting malinger :-). After a chat we agreed one more check in a month to be sure, but I'm more or less in the clear. It was 150 something over 104 back in May.

    Glenn
  • Hmm, not sure I know that much about dialysis.
    Would be interested to know what strategies you're using robokidney
    Is your website working yet
  • Glenn, that's brilliant. You've brought your blood pressure from high to normal by your own efforts. If you're a timewasting malingerer, I wish I had more timewasting malingerers on my list.

    You know now that if you stop exercising and get fat your blood pressure will go straight back up :-(

    My belief in what I do was restored somewhat this morning - I saw a nice young woman (40-ish) who has lost lots of weight, started to exercise and cut out added salt since her BP was found to be high on a routine check and we had a chat about lifestyle a few months ago. She's not out of the woods yet, but she's on the way. Then a young Bangladeshi lass, on the point of leaving the room, said, "You don't know my mum, but she's got diabetes and kidney failure..." and I thought, yeah, where is this leading, and she went on, "My brother and me, we were wondering how to go about giving her one of our kidneys." Given the attitude of our local Asian communities to organ donation ("We'll take but we won't give"), I almost had to ask her to repeat what she'd said to make sure I'd heard correctly. Big hugs all round today.
  • Great story vrap
    I had a nice day too inbetween crises
    One of my dialysis nurses gave me a bottle of gin--not sure why
    She said it was for all my support
    Hope theyre not trying to tell me something
  • Mikey

    When HR is around 110 run feels quite slow and very easy. I can get up to 160+ at end o long runs but very variable. Did Cardiff 10k at weekend in 62 mins with average of 129 and max when sprinting for finish of 140.

    As you say we are all different. I take my tablets as the first thing I do in the morning for no other reason than I would probably forget them otherwise and I think it gives me consistency.

    Keep up the good work and best of luck.
  • V-rap why don't more GP's give patients the option of trying to reduce BP by exercise and diet than by just dishing out pills. Both of my sister-in-laws (different GP's) are on medication, they were given no advice about losing weight, cutting down on salt, exercise etc.
  • WW, I hope all GPs DO give patients the option of trying to reduce blood pressure by lifestyle adaptations before ploughing in with the pills - we are strongly encouraged by those who write the guidelines of such matters (the British Hypertension Society in this instance) to advise at least three months of trying exercise, weight reduction and salt restriction before using medication - and I allow a bit longer if the person is making good progress.

    I see the opposite problem. It's dead easy to pop a handful of pills every morning (I am sure some people estimate their personal worth according to how many pills they "have to" take each day) and go along to the doc every month or two to have a blood pressure check, and if you've really got the abdication of responsibility off to a fine art you can roll all 25 stone of your tobacco-scented flesh into the consulting room, scattering sausage roll crumbs in your wake (well, it's so tiring sitting for half an hour in the waiting room...got to keep my energy up) and, when your blood pressure is no lower than it was last time round, blame the doc for giving you the wrong pills. It's very, very difficult to sustain a diet and exercise programme when you live in a society that is screaming "eat, eat, eat, and don't bother moving" at you.

    And it's true that a lot of GPs and practice nurses know zip about nutrition. It's not a glamorous, high-powered topic. The problem then is that the alternativists rub their palms and hijack sensible dietary advice to piggyback on to their ludicrous panaceas.

    I'm sure there are some overly paternal GPs out here who don't like patients taking charge of their own health, but most of us try not to be like that.
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