blood pressure and exercise performance

S

Sterling

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I am a pilot and have been prescribed a beta blocker for blood pressure in the 140/100 range. 40 years old. No other significant related health issues. Long story short I am looking for another solution. Beta-blocker seems to hurt my exercise (triathlon) performance more than I am willing to tolerate.

Any thoughts on what I should try next that won't upset the Aeromedical division but also won't hurt aerobic exercise performance as much?
 
Reduce salt in your diet. Lose a few pounds (although running tri's probably says you're not carrying a lot of excess weight). Reduce stress in your life.
 
Did the doctor try an ACE inhibitor like lisinopril or an ARB like losartan before they prescribed the beta blocker?
 
If you're running triathlons frequently and are apparently in good shape I don't understand how your resting BP could be nearly high enough for the FAA to care, do you have some odd genetic stuff from your folks going on? Crazy bad diet?
 
No the doctor went straight to a beta blocker. Yes stress is a big part of my life.

My diet is not ridiculously bad but could be improved still. Same for weight.
 
Sometimes it's just genetics. I'm the youngest of 10 kids. My parents and all my siblings were/are pretty height/weight proportionate. There are no overweight problems in my family. Mom and dad both had high blood pressure. I have at least five older siblings on BP meds. I went on lisinopril about 5 years ago at 51.

I'm 6-1, 200#, eat reasonably healthy and don't have huge amounts of stress in my life.

Sometimes it just "is what it is."

Losing 10 to 15# might help me though.
 
Don't get me started on salt. Unless you've got some serious circulatory challenges, salt is NOT an issue. Even further, encouraging someone activing engaged in training for endurance sports to curtail salt input is absolute insanity.
 
Nothing beats weight loss for BP reduction. But if you're already fit, then it could be just genetics. Doctors love to prescribe BB's. Makes everyone much more money than telling you to lose weight. No money in that.
 
I can tell you from experience if you are actively training for endurance sports (I'm a marathoner myself), it doesn't take much of a reduction in diet to start your weight down and race times up. Helps with the other various health yardsticks as well (LDL:HDL ratios) etc...
 
Thanks Ron. Yes weight loss is on the menu. Injured over winter and I picked up 10 pounds. Now back to 100% so ramping back up. I should be able to lose it but I get symptoms if I don't keep diastolic fairly low, so I need to stay on something for now. Max heart rate went way down. Like from 160 to 125 on a long ride.
 
BB will cause your heart rate to lower. I ride bicycles long distances, take atenolol before bed. In the mornings I'm lucky if I can hit 145, in the afternoon and evening I can get higher. My experience is that it is limiting in all out efforts like the hills we have around here, but with training you can overcome most of it, you have to push through it (gradually build of course). I'm training for a 138 mile ride in June, been doing well. I've taken attenolol for over 10 years now and been back to riding for at least that long. Base miles do the trick for me. That said, if you don't need to be on the BB for other conditions, then talk to your doctor, you could probably get it changed over the phone.

Oh, weight gain, (10 pounds will cause my BP to go up), salt, alcohol, carbs and fatty foods all can cause me problems if I don't be careful. I've seen the damage this stuff can do in others, doing everything I can to stay healthy myself. Best of luck, call your doc.
 
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James331 said:
If you're running triathlons frequently and are apparently in good shape I don't understand how your resting BP could be nearly high enough for the FAA to care, do you have some odd genetic stuff from your folks going on? Crazy bad diet?
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One would think. I'm one of those people that goes to the gym seven days a week, rain or shine and puts in a minimum of one hour of cardio in a day, plus 80+ mile bike rides on the weekends. I usually do 100 or more over the course of a weekend. Yet, I still come close to the upper limit of the Class 3 BP limits when I'm in any kind of medical exam. Otherwise, if I check it using my own device it ranges from up there to a more closer to normal 130/85.

It runs in the family, and nobody has died from a stroke or heart attack.
 
Triathlons, food, your job, none of it is as important as keeping your BP in line. Hypertension eats away at arteries and veins continually, it's a really bad thing. Hopefully you can sue diet and exercise to keep it in check, but it could be genetics is against you. In that case, take that damn meds (or find ones that work better). Screw the triathlon.
 
steingar said:
Triathlons, food, your job, none of it is as important as keeping your BP in line. Hypertension eats away at arteries and veins continually, it's a really bad thing. Hopefully you can sue diet and exercise to keep it in check, but it could be genetics is against you. In that case, take that damn meds (or find ones that work better). Screw the triathlon.
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OK I guess I didn't ask my question explicitly enough. I am looking for an alternate to a beta blocker to control blood pressure that won't make a 3rd class medical difficult. I don't know why you think it is necessary to tell me to take my meds and "screw triathlon". My primary care doc is not going to be able to tell me which medications will cause certification problems.
 
Sterling said:
OK I guess I didn't ask my question explicitly enough. I am looking for an alternate to a beta blocker to control blood pressure that won't make a 3rd class medical difficult. I don't know why you think it is necessary to tell me to take my meds and "screw triathlon". My primary care doc is not going to be able to tell me which medications will cause certification problems.
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Most are acceptable, all have things you need to watch for when you exercise to the extreme like a triathlon, talk to your doctor about it and your AME. Here is the guidance from the FAA: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/antihyp/
 
Sterling said:
OK I guess I didn't ask my question explicitly enough. I am looking for an alternate to a beta blocker to control blood pressure that won't make a 3rd class medical difficult. I don't know why you think it is necessary to tell me to take my meds and "screw triathlon". My primary care doc is not going to be able to tell me which medications will cause certification problems.
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Because you said that
Sterling said:
Beta-blocker seems to hurt my exercise (triathlon) performance more than I am willing to tolerate.
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This suggests to me that you value your exercise regimen more than keeping your BP under control.
I admittedly could be wrong, it is only the internet.

Remember, for all you know beta-blockers give you the best relief with the fewest side-effects. I hope it isn't so, but you haven't any data yet to indicate otherwise.

This should answer your question, though.
 
My BP was in your range and I tried the Beta Blockers, it was a no go for me. So I researched and tried many things.

The one thing that worked for me (and a few others since) is being vehement about making sure your potassium intake is 2x your sodium intake. IE: 2300mg / day sodium = 4600mg / day potassium. (its difficult at first, lots of Spinach, bannanas, sweet potatoes, oranges, ect)

Yes I naturally lowered my sodium intake by virtue of eating better, but regardless It wasn't the sodium, your body needs both to balance each other, that was the trick.

I am blown away by how much my doctor thought this was not a big deal, but it was the cause of my high blood pressure.

FWIW- I also cut down sugar intake to 1/8 what it was and my blood pressure came down even further.
 
Thanks all.

For future searchers, changing to a different beta blocker, bystolic, known to have less of this effect than bisoprolol.
 
Sterling said:
OK I guess I didn't ask my question explicitly enough. I am looking for an alternate to a beta blocker to control blood pressure that won't make a 3rd class medical difficult. I don't know why you think it is necessary to tell me to take my meds and "screw triathlon". My primary care doc is not going to be able to tell me which medications will cause certification problems.
Click to expand...

So last year I started back into flying, I was going LSA as I was not sure I could get my class 3 back.. after checking into it, Yes, I could. I'm on Lisprel for BP, running 130 to 135 / 85 until I walk into a DR office... Lisprel was listed as being approved by the AME, so its good that I was on that one... during the exam, after taking my BP 3 times, it was finally low enough to pass.. I told the AME that it is high every time I see a DR, showed her my daily recorded measurements for the last month, and all was well... back into flying after 20+ years away.

I think it is important to be on the right base meds, and some of the Bata Blockers were not acceptable.. Look through the ones that are approved for local AME approval and see if changing to them will work...
 
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