Atenolol and exercise.

[J Host Neon]

A year ago at the age of 44 I was diagnosed with high blood pressure and prescribed 25mg Atenolol daily. I was 40-50lbs overweight and in the past year have returned to competetive cycling to help weight management.

I'm now riding 40 - 50 mile training rides and about 100 miles weekly but find I've got to a level where no amount of extra training improves my performance, particularly on hills. Cyclists of the same age are often faster. Similarly when using a heart rate monitor I can't seem to get my heart rate above 140bpm whatever I do, whether in the gym or on the bike. I assume this is an effect of the drug. Also I don't get out of breath when training as much as I used to. Does this mean the drug prevents me from working anywhere near my anaerobic threshold?

Will no amount of training alow me to improve so long as I keep taking Atenolol?

As my level of fitness is greatly improved compared to when I began taking the Atenolol and my weight reduced (by over 30lbs) and bearing in mind the low 25mg daily dose is it logical that if I stopped the medication the higher intensity training I might undertake would benefit my condition?

[CCF-M.D.-RCJ]

J Host Neon,

Congratulations on your weight loss and improved fitness.

I find that some of my patients, perhaps 25%, who lose weight are actually able to stop their hypertension medicines.  The other 75%, unfortunately, still need a medicine to lower the blood pressure.

The atenolol certainly might be impairing your exercise capacity, and preventing you from attaining a higher heart rate than 140.  On the other hand, your target heart rate is 148 {(220-45)*0.85}, so you are not too far from your goal.

Be careful using logic to try to outsmart biology.  I was an engineer before going into medicine.  Some of my earliest mistakes came from trying to apply logic to medicine.  Some things in biology happen just because, even in the face of what might be intuitive, or logical.

However, many other medicines exist to treat hypertension.  Some good choices for you might include diuretics or ACE-inhibitors.  Neither of these medicines would be likely to reduce your exercise capacity.  Talk to your doctor prior to stopping or changing your medicines.

Again, congratulations.

Hope that helps.

[3rdMajor]

Hi,

No doubt the atenolol has put an artificial ceiling on your max heart rate.
You say your level of fitness is greatly improved, but remember that you got back into cycling for health reasons.  Health and fitness can be two different things.
I was very fit in my mid 40s.  I lifted weights and played basketball "competitively" 4x a week.  I didnt wear my poor diet on my waist line. I didnt know what my blood pressure was. I was fit, but far from healthy.  I developed angina on the basketball court,  and subsequently underwent 5x bypass surgery.
The moral of my story is not to worry where you finish in the pack, but about your blood pressure and other risk factors for an early finish due to heart disease.
Let your fitness be secondary to your health.
Where is your blood pressure after the loss of 30lbs?

[MarkSw]

I am a 48 year old male, also on Atenolol (50mg daily), which has successfully brought down my BP from around 190/100 to typically 125/75. It has also reduced my resting heart rate down from typically 80-90 to the 45-55 area. I switched to a beta blocker because for me the diuretic drug that I was tried on first was ineffective (very marginal if any impact on my BP). So, in my case, since they are dramatically effective and I don't suffer any side effects to speak of, beta blockers are the obvious choice.

However, like you I exercise regularly and I find that I have to work quite hard just to get my heart rate up above 120, and other than erratic peaks, 140 is about the absolute upper limit that I can sustain for any length of time. Without the medication I believe my peak would probably be somewhere in the 170-190 area, but I have not put this to the test recently.

Having said that, my own experience is that in the long run the real reduction in athletic ability as a result of the beta blocker medication has been very slight. On the whole I feel that my heart and body have simply adapted to the lower BP and pulse rate by doing more work per heart beat, and I certainly don't have any particular trouble keeping up with people, apart from those who would be a lot quicker than me anyway regardless of my medication.