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Beta Blocker and target heart rate

Does being on a beta blocker make it more difficult to lose weight? I have been reading that being on a beta blocker reduces your heart rate. Since I been taking Atenolol for high blood pressure I have packed on weight even though I am still excercising.

Is there a different alternative for HBP medication?
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976897 tn?1379167602
The beta blocker should still let you obtain your max heart rate, if it doesn't, then you are probably on too high a dosage. The main idea of the beta blocker is to stop it reacting quickly to hormones like adrenaline. Sudden surges of this through your body during periods of stress will quickly get your heart racing, but beta blockers block those receptors on the heart.
There are alternatives for blood pressure control, and I'm wondering why beta blockers were picked. Do you have a known heart problem? There are good ace inhibitors for blood pressure control, such as Ramipril. When I was on beta blockers it took me longer to achieve my max heart rate, and work up a good sweat.
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367994 tn?1304953593
Q: "The beta blocker should still let you obtain your max heart rate."

>>>That is untrue.  A beta blocker prevents one from reaching a maximum heart rate.  I have been on coreg (beta blocker) and anyone who is on a physical exercise program knows the heart rate cannot be reached when on beta blockers.

The best medicine for high blood pressure is an ACE inhibitor (mine is lisinopril for more than 7 years).  I also take coreg (beta blocker) to stablize the heart rate. ACE inhibitor mechanism to lower blood pressure is to block the angiotensin produced by the kidneys...the enzyme constricts vessels and the heart pumps against higher resistence causing high blood pressure...more resistence the higher the blood pressure.

Thanks for your question and if you have any further questions or comments you are welcome to respond.  Takce care,

Ken

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237039 tn?1264258057
Yes, Altace is another good ace inhibitor.  I was taking both the beta blocker and the ace inhibitor. One was taken for the heart rate the other for hbp and heart rhythm, but my blood pressure dropped too low so the ace inhibitor was taken off my list of meds.  I did gain about 30 lbs after my first heart attack only because I was afraid of dropping dead if I did exercise.  Now that I know it is in my best interest to exercise I was able to get back to the weight I was at as a teenager. And I have no problems with my heart rate, rhythm or angina.  You may have to keep working with your doctor until you find the right med and dose.  I am still working with my doctor and my first heart cath and stent was 7 years ago.  Take care, Ally
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976897 tn?1379167602
"That is untrue A beta blocker prevents one from reaching a maximum heart rate"

Then that means nobody should attend rehab where their max heart rate is calculated. If they cannot reach it, then what's the point. When I was on a beta blocker at rehab, they calculated my HR to be 220-age = 173 and they then subtracted 20 to account for beta blockers. So my max rate was 153. I could EASILY reach that. When I was literally overdosed with BB, then the most I could achieve was around 110, but that was through negligence. There are 15 people in my rehab group and they all achieve their max heart rate.

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Avatar universal
Seriously, when you have a coronary problem, as I think you have, and you are on your personal dose of BB, you cannot use any formula to define your max HR. The only serious way is with an stress test.

As per the effect of the BB on HR, I can tell you that I train myself at a certain HR... and the slope that I need in the treadmill varies inversely to the numbers of ours since I took it.

Any way, receive my congratulations, it seems that your heart is in a very good shape if you are able to train at 153bpm.

Jesus.
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367994 tn?1304953593
No comment whether or not you overdosed and your experience!  I see you have researched the subject, and you have correctly reported the calculation for HR for those taking a beta blocker, but you already knew BB lowers and manages HR at a lower level target rate and you were referring originally to the new calculation to compensate for beta blocker medication weren't you?  I made the correction so a reader may not be misled. You understand that don't you?.

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367994 tn?1304953593
Q: "Seriously, when you have a coronary problem, as I think you have, and you are on your personal dose of BB, you cannot use any formula to define your max HR. The only serious way is with an stress test".

I agree and that is why I judge my effective cardiovascular based on METS.  The stress test I had showed 7 METs to be optimum.
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976897 tn?1379167602
"Any way, receive my congratulations, it seems that your heart is in a very good shape if you are able to train at 153bpm. "

That is when I was on beta blockers in 2007, now I can train at 180 and with no discomforts.
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63984 tn?1385437939
I hesitate to post, as there is great difference of opinion on the topic, but here goes... In 1999 I had a heart attack and was given a beta blocker, a mild dose.  I was encouraged to exercise, which I did.  My weight went up as my heart rate went lower.  I was in  physical rehab, and my heartrate slowed to about 100bpm, much slower than I experienced before the beta blocker.  As time went on, my body got used to the drug, and the weight went off, the heart rate climbed a bit.  As my heart function dropped, I was given higher doses, the weight went up quickly, but as the body got used to it, the weight dropped.  At a point, I had to take Coreg, a very strong beta blocker drug.  I was started in very small doses, and my weight climbed again, and when I went on gorilla doses, it went higher.  Again, as I continued to exercise and control my diet, the weight left.  However, never could I get my heart rate higher than 110 bpm in the twelve year period.  in my opinion, beta blockers slow the metabolism, and weight can indeed accumulate.
A month ago I had bypass surgery, and Coreg was dropped.  I had a big drop in weight, but that could have been the surgery, even though I gained 28 pounds of water after the surgery!  I started physical rehab, and had to have my beta blocker increased as my heart rate jumped to 160 after three minutes of 2.5 met activity.  My beta blocker was increased, and my heart rate is now 110 at 2.5 mets.  
Cutting to the chase, I think you are correct, beta blockers can cause weight gain, at least in my experience.  I think your body will sort it all out if you continue to work out and eat a cardiac healthy diet.  I'm 6'3", I weighed 245 pounds at the start of my cardiact adventure years ago, today I'm 6'1/2" (that happens when you are old) and weigh 183.  Take the drugs, do the workouts, follow the diet.. that worked for me.
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367994 tn?1304953593
I never had a weight problem with a beta blocker but to lose weight requires a high MET calculation, but a beta blocker for me provides an inconsistent heart rate that does not correspond to my physical limitations...limitations being shortenss of breath and leg muscle fatigue.

Just now doing some research on the subject I found a recent article that makes more sense for me.  A stress test has indicated my limitations at 7  METs, and the METs (metabolic equivalent test) is useful for an evaluation of vital signs with exertion but to lose weight your calorie intake should be lower than your metabolism metric. You may have to increase your MET parameter  to lose weight, and whether your cardio can sustain an increase of a higher heart rate safely may require a stress test if you are a heart patient.
.
I have been listening to my body symptoms for about 6 years to gauge degree of cardio exercise that is appropriate for me and no attention to heart rate. The following article makes good cardio sense for those individuals on medication.

Source "We can, however, provide some advice based on scientific research: Listen to your body. The level of effort you feel you are putting into an activity is likely to agree with what actual physical measurements would show, researchers have found. In other words, if your body tells you that the exercise you are doing is moderate, measurements of things like how hard your heart is working would probably show that it really is working at a moderate level. During moderate activity, for instance, you can sense that you are challenging yourself but that you aren't near your limit.

One way you can estimate how hard to work is by using something called the Borg scale, shown below. It was named after Gunnar Borg, the scientist who developed it. The numbers on the left of the scale don't indicate how many times or how many minutes you should do an activity; they are just a way of helping you describe how hard you feel you are working".

http://www.medicinenet.com/script/main/art.asp?articlekey=10259
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976897 tn?1379167602
The borg scale has been used in rehab for years, but to be honest, although the principle is good, it really isn't easy to use. For example, at regular intervals, they walk around, take your heart rate and show you a chart (borg) from which you have to pick a number. I think 13-16 is very confusing and how can you put that into real terms. You always ponder over it in your head after giving the number, wondering if it was really correct.
If I'm on the exercise bike, I can pedal 20km on level 1 with no problem making it a 9(very light). Then when up to level 7, I can't tell if it's a 13,14,15 or 16. If your legs ache, but you aren't sweating or breathing fast or have a heart rate over 100, do you incorporate this into your factoring and say 13? I suppose what I'm confused with is the qualifier for 'hard'. Does it relate to your limitations with the heart? your limitations with muscles? breathing? all of them? Should someone with aching muscles but no shortness of breath or chest pain push harder? I thought it was just me, but when I asked other patients in my group how they determine 13-16 they all said "I just pick a number".
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367994 tn?1304953593
I don't use any esoteric method to determine my physical limitations...its a judgement call and it comes with knowing one's own capacity.

I have been asked to elaborate by some e-mail responses to beta blocker effects on target heart rate with exercising parameters. IMHO I stated the effective heart rate could not be determined when medicated with a beta blocker, and that was my experience. For support to that comment I provide a link that a doctor (Mayo Clinic) states HE can't predict in advance a target heart rate for exercising when medicated...requires stress test to determine exercise dynamics with a beta blocker. Also, I commented I do not use heart rate to regulate my exercise routine, but rely on comfort level with no shortness of breath or fatigue.

Regarding weight gain it relates to MET and colorie intake.  It is postulated that a beta blocker slows down metabolism.

___________

Source:
While training under the influence of beta blockers, you might notice that your heart rate fails to increase past a certain threshold no matter what you do. If you are in the habit of using a heart rate monitor this can become disconcerting, as you might feel that you are unable to achieve a quality workout while using beta blockers. If this is adversely affecting your workouts, the physicians at the Mayo Clinic recommend that you stop judging workouts based on heart rate, and start using a more subjective "perceived level of exertion" scale. This is merely a ranking (from 1 to 10) given by you to label how difficult any particular exercise is.

Read more: The Side Effects of Beta Blockers & Exercise | eHow.com http://www.ehow.com/about_5489171_side-effects-beta-blockers-exercise.html#ixzz1SEGKZFMX

Beta Blocker Effects

If you exercise while taking beta blockers, the medication-related decrease in your heart rate can make it impossible for you to reach your normal target heart rate, according to Dr. Sheldon G. Sheps of the Mayo Clinic. This holds true regardless of the effort you put out during exercise. However, your doctor CAN'T predict in advance how much your medication will affect your target rate. To determine the effects of a beta blocker, you will need to undergo a procedure called an exercise stress test, which measures your heart's reactions in a highly controlled exercise environment. Using the results of a stress test, MayoClinic.com says, your doctor can appropriately recalculate your target heart rate.


Read more: http://www.livestrong.com/article/302615-beta-blockers-exercise/#ixzz1SEJA4VDZ

Beta blockers are used to treat conditions such as high blood pressure and migraines. Doctors aren't sure exactly why some beta blockers cause weight gain. It could be that beta blockers slow your metabolism. Also, if you switch from taking a water pill (diuretic) to a beta blocker as a treatment for high blood pressure, you may gain a few pounds of weight that the diuretic kept off.

If you haven't had an exercise stress test, you can use a perceived exertion scale, such as the Borg scale, which relies on your OWN JUDGEMENT of how hard you're working based on effort, breathlessness and fatigue (I don't need any numbering system to determine my exercise protocol). Ask your doctor for help finding and using an exertion scale. For most workouts, your best bet is to aim for moderate intensity (moderate intensity is fine for me within my MET range!)
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212161 tn?1599427282
I've been on a beta blocker for 26 years and never had a weight problem with them
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Avatar universal
Hello,
I am a RN in the Cardiac Rehab setting and I agree that most patients feel the same way you do about the Rate of Perceived Exertion (RPE) scale. I hope this simplifies your concern.
The #'s correlates with how hard YOU FEEL the workout is.
13=somewhat hard and able to talk
14= Able to talk but don't want to
15=Hard: Able to push and still keep proper form
17=Very hard: Can keep a fast pace but only for a short time
If a heart patient works at a 15, they should be doing interval training and are at 15 for a minute or less then decrease the workout to a 12-13 for 2-3 minutes/alternating accordingly.
To make it simple, during exercise you should be able to talk if needed. You are working too hard if you cannot talk. Slow down or speed up accordingly.
Good luck and remember to exercise at a minimum at least 20-30 minutes a day, resting on Sundays if needed.
Cardiac Rehab RN
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976897 tn?1379167602
Thank you for that information. Something else which has confused me in the past is whether to be overly concerned with regards to particular symptoms. For example, if you exercise for 2 minutes and there is no shortness of breath, but throat discomfort appears, do you push and try to ignore it? I am assuming that if you have angina symptoms then the heart muscle is complaining of being short of oxygen and the cells are being damaged. I have asked many cardiologists this question but none seem to have a straight answer. One cardiologist said "carry on exercising" to which I replied "So you are saying no cell damage is occurring ?" He then suddenly changed his mind and looked full of confusion.
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