This is a reprint from John Post, the Rock Star Triathlete Medical Director’s, most popular blog. So many of us have elevated blood pressure and the choice of medication can be very important to the triathlete.
I’ve seen questions about high blood pressure recently, or hypertension as your doctor would call it. Many of us, including this author, take daily medication for this condition and wisely so. I recently fielded a question from a reader about his anti-hypertensive medication, Inderal, and it’s effect on his heart rate. I thought the response would do well here.
Ed-I’m John Post, MD, the medical director of Training Bible and Joe Friel’s forwarded your e-mail to me. I think your answer is more complex than you’d anticipate. You don’t mention why your physician has prescribed a beta blocker for you. As you’re likely aware, this class of drugs can be useful for a host of issues including hypertension, migraine prophylaxis, glaucoma, and heart rhythm disturbance to name a few. One indication I find quite interesting is using it for “nerves” or “stage fright,”…the yips, as they are frequently taken by musicians when performing on stage to combat performance anxiety. The World Anti Doping folks take a dim view when they are illegally used by archers or shooters as NBC showed us in the 2008 Beijing Summer Games when they DQ’d one of the shooting medalists.
When you take a beta blocker for hypertension you note a reduction in heart rate, the primary mechanism of action of this class of drugs. This would pertain to resting, submax and maximal HR. For the non-athletic world this is a good thing and in many cases will actually increase longevity given selective symptoms. That said, some patients are more susceptible to the side effects and complain of lethargy, a decreased ability to exercise and the feeling that it’s hard to push themselves to the max.
So, with respect to HR Training , HR zones, AeT and your goal to push a bike 25 mph. The use of tables or methods intended for those not on these agents will not work for you. I talked to my friend Jay Dicharry who runs the University of Virginia Speed lab, and has had thousands of athletes in the lab for LT testing, AT determination and the like, and he suggested that the most accurate way to figure out your individual zones, etc. was on the bike in the lab and do serial blood tests-at the same time of day (and on the same dose of medicine) as your normally train. And, it’s not all that expensive. From these data points, you and the trained professional could simply crunch the numbers and come up with the best estimate for you. There’s probably one of these in your area but if you find yourself in Virginia and wish to schedule one these, Jay can be reached at 434-243-5605. In fact, he did my treadmill testing.
Lastly, assuming you take this for only hypertension, there are other classes of agents that work by different mechanisms of action that your family physician has in his/her armamentarium that might also be appropriate for you that don’t work through HR modification. Why not have that discussion next time you’re in the office? Good luck and safe training.
John Post, MD
Medical Director, Rock Star Triathlete Academy