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Discussion Starter · #1 ·
Couple of years back, I got diagnosed with essential hypertension. Not really that high (140/80 max), but something the doc's wanted to get lower. I started on Cozaar which completely reversed my left ventricular hypertrophy, but I was still having some arrythmia's, so the doc recommended Toprol XL. I started this at 25mg's and it helped a bit, but over a year or so, they moved it up to 100mg. This is because they took me off the diuretic due to cycling in the heat of Florida.

A year later and I'm completely screwed! Blood pressure looks great, but I have no energy and I'm getting dropped on the easiest of rides. State time trial was a disaster and life in general just sucked as I was getting more depressed because of my lack of energy.

So last week, I switched to a new doctor. Explained to her everything about my history, how much I cycle and why I didn't think this drug was the best match for me. She put me on a plan to find a new way to control this and still allow me to pursue cycling. This week was the first change. We added a bit more Tekturna and dropped the Toprol XL from 100mg to 75mg.....WOW!!!! My heart rate goes to a higher level now and my legs aren't dead on base training rides. A year ago, I could hold at 180bpm without breathing too hard. A month ago, getting to 150bpm had me out of breath and my legs were screaming and I wouldn't recover for days. Today, I was at 175bpm and didn't notice it until I looked down at my Garmin. If my BP stays good for 2 more days, the plan is to drop it to 50mg and re-evaluate at the doctor's office after the weekend.

If anyone else has run into this same kind of issue, I'd appreciate hearing your experiences and how it worked out for you.

Thanks!

Scott
 

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I am on beta blockers for an entirely different reason, so I don't know if my experience is relevant. I have Atrial Fibrillation, but this does not affect my blood pressure. I take 160mgs. of Beta Pace (Sotalol) twice per day. It does not seem to have a negative effect on my cycling performance and my energy levels are fine. I do not know if this drug is appropriate for your condition, but it couldn't hurt to ask.
 

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Hypertension has had me atenolol, benazepril, and hydrochlorothiazide for years now. My max heart rate is about 120 and my resting heart rate is 52. On a typical ride I usually get my heart rate to about 108 and work hard to sustain it. My legs are dead for the first ten to fifteen minutes, I get dropped easily, I can't climb for squat, and recovery is slow. On the other hand, I'm very much alive. I still love to ride. Competition is something I observe. My bike is a head turner and my wife thinks I'm a stud.
 

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I also had atrial fib. Fortunately, I had an ablation which completely fixed it. When I was in A. Fib. I was on Toprol. That stuff absolutely "killed" me. No matter how hard I worked, my heartrate would NOT go above ~ 125 bpm, even at 110% effort. People that I used to drop like rocks were then just flying past me. I was powerless to do anything about it. It was a great day when I was able to get off that stuff.
 

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Discussion Starter · #5 ·
Another day in...BP is still 120/66 and pulse is 55. The best part....I feel great! Legs don't hurt and I actually got a good night's sleep. Tonight I'm doing some TT intervals and I'll see where it goes with my HR and Power....
 

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My Experience With Beta Blockers

Over the last several months I have experienced what have been diagnosed (after much costly testing) to be premature ventricular contractions (PVC) a common form of arrhythmia. I am currently trying Metoprolol which is another name for Toprol-XL. I have been on a dose of only 25mg daily for 14 days now.

In my typical rides, I now find that my heart rate at maximum output (while climbing) falls 10-15 bpm below what it typically was prior to all this. I also find that my legs tire easily and feel as if lactic acid is building far faster than before. I can still do my rides but things seem harder than before. My average speeds over these same courses is not any faster so I do not thing that the reduced heart rate I am seeing is a function of improved conditioning.

My dose is very, very low. I still get the episodes where I can clearly feel the PVC in the form of heavy thumping in my chest, slight wooziness, and fatigue. However, I have only rarely felt these while riding. They occur typically when off the bike (like right now).
 

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I was on Toprol for about 2 months. I didn't like the way that it made me feel and the doctor moved me to Diovan and then to Accupril. While on Toprol my resting heart rate dropped and I would have chest pains. I have very similar blood pressure to you and the other medications were far better with little to no side effects. I have spoken to others who had similar reactions to Toprol. Seems odd that doctors reach for this drug first when it has so many side effects.
 

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Your performance will definitely be affected on beta blockers, particularly with strenuous exercise. The medication has both negative chronotropic and inotropic effects on the heart. Simply put, the heart will not beat as fast, nor with as much force on the medications. When you exercise, the muscles require more oxygen and create more waste products. Heart rate and stroke volume increase to meet the demand, but beta blockers prevent this. The effect will be more pronounced with more strenuous exercise.

In people with essential hypertension, there is no need to use a beta blocker as first line treatment, particularly in someone exercises frequently. Also watch out for the older Calcium channel blockers such as Verapamil. Better choices would be water pills (diuretics) or ACE inhibitors or ARBs (like Diovan or Accupril). These medications all affect salt and blood flow in the kidney instead of the heart. The only time beta blockers would be needed would be if there were significant arrhythymias or if there was a history of a heart attack.

Make sure you ask your doctor if the medication will affect your athletic performance before he/she gives you a new prescription.
 

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I weaned off a beta blocker quickly over 2 weeks. When on it I could ride for hours because I never went fast, max HR about 110. My first day off the stuff my HR hit 180 running a flight of stairs. It took about a month for my adrenalin system to reset itself.
 

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Discussion Starter · #11 ·
whitedavidp said:
Over the last several months I have experienced what have been diagnosed (after much costly testing) to be premature ventricular contractions (PVC) a common form of arrhythmia. I am currently trying Metoprolol which is another name for Toprol-XL. I have been on a dose of only 25mg daily for 14 days now.

In my typical rides, I now find that my heart rate at maximum output (while climbing) falls 10-15 bpm below what it typically was prior to all this. I also find that my legs tire easily and feel as if lactic acid is building far faster than before. I can still do my rides but things seem harder than before. My average speeds over these same courses is not any faster so I do not thing that the reduced heart rate I am seeing is a function of improved conditioning.

My dose is very, very low. I still get the episodes where I can clearly feel the PVC in the form of heavy thumping in my chest, slight wooziness, and fatigue. However, I have only rarely felt these while riding. They occur typically when off the bike (like right now).
That's exactly how I have felt for the last year! Still feeling better and am going down to 50mg's today....
 

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Discussion Starter · #12 ·
drc said:
I weaned off a beta blocker quickly over 2 weeks. When on it I could ride for hours because I never went fast, max HR about 110. My first day off the stuff my HR hit 180 running a flight of stairs. It took about a month for my adrenalin system to reset itself.
My HR definitely is able to move now. I could always get back up to 170bpm, but it wiped me out 2 weeks ago. Yesterday I was cruising at 175bpm with no problems. I am setting my Garmin to alert me if I go above that for the next few weeks to make sure I don't over do it.
 

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Discussion Starter · #13 ·
Now I am down to 50mg's of Toprol and I am definitely able to recover better. My HR definitely goes higher now so I've been taking it easy and not going over 180bpm. With the Toprol XL, I would start getting ragged breathing at 155bpm. It now is back up to 180 or so and feeling a lot more "normal".

My legs feel so good today after my ride yesterday, that I am actually going to go the gym and do some squats!
 

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Similar Experience

I had a similar experience when I was on an ACE inhibitor.

I hope your current regimen works. But if not, you might want to ask your doctor about trying an Angiotensin II Receptor Blocker. I've been Avapro or Avapril (Avapro with a diuretic) for many years and have had no side effects at all except a little light headedness when I get up sometimes.
 

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I'm on 25mg Toprol and 20mg Benazipril HCL. I haven't noticed any performance effects, but I don't cycle at a real high level. My resting pulse is in the 50s and I can get my HR in the 140s aerobically sustainable when running, with bursts into the 150s (this is at age 61).
 

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Discussion Starter · #16 ·
Pulled some nice intervals this morning on the TT bike at 25+mph. HR went up and came back down nicely. I'm going for heavy intervals tomorrow to measure the true difference. I'm hoping to see a bit more performance or at least the potential for better performance. A couple more TT's have opened up for the end of the year and I'm feeling good enough now to put some effort into training for them....
 

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I have been on Toprol for 5 years

I take 100mg every day since being diagnosed with a heart attack in 2002, caused by coronary artery disease (genetic, nothing to do with diet or excerisize levels). The Toprol limits my max heart rate to somewhere around 160.

The noticeable affects is that once I reach max, that's it. I simply can't go any faster or harder at that point. The main affect it has had is that when I climb hills, I am limited in speed. Even though I like to ride in the mountains as much as possible, I get dropped on all long climbs. I just live with it.

The Toprol is especially noticeable when the climb is steep. Recently on a ride, we rode up Monteagle Mountain to Sewanee, TN. The climb is only 2 1/2 miles long but is very steep - some short sections as much as 18%. By the time I neared the top, I could only go about 4 mph. I felt OK and was not especially tired, but I just couldn't do any more or go any faster without bonking. My speed is just limited, period. I used to use a heart rate monitor (no longer bother with it) and I could see exactly when I hit the limit. But a HRM is not needed because I can simply feel it when I reach max HR.

The other affect is when I am on a fast training ride, I can hang OK when in the draft but I simply cannot maintain speed when pulling once I reach max heart rate. It is very difficult if not impossible for me to do a lot of anaerobic training, much less any racing. Therefore, I mostly do long rides and tours.
 

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Discussion Starter · #18 ·
That was the same experience I had. Although we don't really have too many hills here in Florida, I would reach a point where my legs just would not go any more. Now that I am down to 50mg, I've been able to lift weights and ride with much better recovery. I actually am looking forward to riding again!
 

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The issue of high blood pressure is interesting. I had a well respected Italian doctor tell me that American doctors basically treat everyone to statistical averages. Why should someone who works out regularly at intense levels have the same blood pressure as the average American couch potato? Athletes have lower resting HR- should we be taking drugs to get up to the average 72 BPM? I have looked for evidence of high BP and heart disease and have found only studies showing correlation. This doesn't necessarily mean that high BP causes problems. My doctor (American) suggested that I should try to get my BP below 140. I am 61 and have a max HR of about 180 and do tough mountain climbs at altitude. I hit 178 last week on a 7 mile climb to 9000+ feet. I personally think that most doctors have been sold a bill of goods by the drug companies with regard to BP and "treating" high BP. Should be be medicating the whole population to "average" blood pressure levels? Anyone else looked at these issues?
 

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whc said:
The issue of high blood pressure is interesting. I had a well respected Italian doctor tell me that American doctors basically treat everyone to statistical averages. Why should someone who works out regularly at intense levels have the same blood pressure as the average American couch potato? Athletes have lower resting HR- should we be taking drugs to get up to the average 72 BPM? I have looked for evidence of high BP and heart disease and have found only studies showing correlation. This doesn't necessarily mean that high BP causes problems. My doctor (American) suggested that I should try to get my BP below 140. I am 61 and have a max HR of about 180 and do tough mountain climbs at altitude. I hit 178 last week on a 7 mile climb to 9000+ feet. I personally think that most doctors have been sold a bill of goods by the drug companies with regard to BP and "treating" high BP. Should be be medicating the whole population to "average" blood pressure levels? Anyone else looked at these issues?
Well, interesting questions but not directly related to beta blcokers. I do not have nor have I ever had high blood pressure. From what I can read, beta blockers are routinely given to heart attack patients. I still don't understand fully all the reasons, but it isn't related to blood pressure, at least in my case. What I do know is that beat blockers do inhibit athletic performance to some extent. They not only keep me from sustaining high anaerobic effort, but they keep me from training above my metabolic threshold, which is needed in order to improve speed and power. For now I am stuck with long rides at average pace - which to me means I can ride a century on flat roads at 17-18 mph but not at 19 or 20 mph. no matter how much I train. It also means that when I climb any mile or longer climbs at greater than 6% I am relagated to 7 mph - period.
 
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