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  • Significant Pulse Decrease with Atenolol

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    Old 02-28-2011, 04:54 AM   #16
    atengnr
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    Re: Significant Pulse Decrease with Atenolol

    Im glad that I have been a help.

    You may be aware that the vast majority of people with hypertension have whats known as essential hypertension. This means that the cause can not be identified (though it likely will be someday). This is most likely your case, although all known causes have not been ruled out yet (renal artery stenosis). Ask your cardiologist about ruling out secondary causes.....

    High blood pressure occurs even in young fit people. Your case is similar to mine in some ways....I developed htn at age 20, was always active and relatively fit.

     
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    Old 02-28-2011, 11:51 AM   #17
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    Re: Significant Pulse Decrease with Atenolol

    yeah, I hope to get it solved soon.
    Atenolol is working well for me so far... only noticeable side effect is an occasional tingling in the hands, likely due to the low pulse.

    do you think it's safe to exercise yet? would jogging at maybe 6mph for 2 miles be too excessive? maybe I should just walk a mile or two, until my body adjusts to Atenolol.

     
    Old 02-28-2011, 12:36 PM   #18
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    Re: Significant Pulse Decrease with Atenolol

    this discussion has particular interest to me...as you guys know i'm sure (mikevm you may not)...i AM an endurance athelte...not olympics...but marathons, etc. 33 years old and been on lisinopril 20mg - 30mg since age 28. i've always wondered if BB would be better for me because a lot of my BP issues are personality/anxiety related...and genetic i'm sure. my only concern has been the pulse...current reading = 48...drops to low 40s/high 30s sometimes...but usually hangs 48 - 52 i'd say...and tops out around 175 when i'm racing. BP at last check was 128/60...had a few beers sat night and checked it...about 120/50...but can hit 150/90 under stress/anxiety. doc said i could try metoprolol...25mg...but i'm worried about the pulse...not so much that it will drop even lower...but that it will affect my endurance...although there are times where i think it could be the perfect med for me...guess i should just try it. my issues are more with anxiety though (not BP - although i think this is a BP problem)...so doc would rather see me try an SSRI...but i have green light to try metoprolol as well. there is a part of me that thinks it might be the answer out there that i've been hoping for...so why the heck not try it for a few days...but...i have these anxious thoughts about my heart being unable to perform at 'max' and if i need to save my kid in the street from a car, run from a bear, swim a mile in an emergancy situation...that i won't be able to function. just afraid the BB will take away a lot of my cardio strength that i have worked so hard to build. some say 25mg of metoprolol is nothing...i've heard others say it really takes a toll. just to give you guys a sense...i ran 6 miles each day last week, mon - wed...biked hard on friday...followed up by an hour boxing session...and ran 17 miles on saturday...and helped a friend move all day yesterday. this is a normal week...but i FEEL i need to run this much to get rid of the anxiety...i would potentially welcome just taking a pill and not feeling the need to run all the time...but just don't want to take away from my abilities either...anyway...just rambling...glad to hear the atenolol is working and just knowing it might be an option for me someday helps. off to the gym...

     
    Old 02-28-2011, 02:12 PM   #19
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    Re: Significant Pulse Decrease with Atenolol

    As previously noted in this post, beta blockers reduce endurance quite commonly. While others on this forum disagree, I think the difference is a matter of what their underlying issue is. If you only have hypertension, my understanding is that beta blockers will reduce endurance, in a dose-dependent manner.

    I have taken beta blockers for 8 yrs, and while Im not a great athlete, I have played lots of basketball, done some running; and the effect on endurance is HUGE for me. I cannot run faster than a 9 minute mile, no matter how hard I try to get faster. And surely it is logical - my max HR is 130 ish on beta blockers (Im 32 yrs old). So I just go out there and meander along anymore.

    My opinion - if you are an endurance athlete who really tries to get peak performance out of your body, I think you will lose endurance. It will pull down your peak HR. BUT I think theres a good solution for you - carvedilol, Bystolic or Labetalol!!! Try one of these if you want a beta blocker. These have alpha blockade included which vasodilates, leading to minimal effect on cardiac output (or so they say. Its hard to imagine that theres no effect, but certainly far far better than ALL the other beta blockers).

    Ive been on these agents and couldnt stay on them for other reasons, but it surely improved my endurance, basically overnight,when compared to betaxolol (regular old beta blocker)

    Last edited by atengnr; 02-28-2011 at 02:13 PM.

     
    Old 03-01-2011, 12:19 AM   #20
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    Re: Significant Pulse Decrease with Atenolol

    really hope the tingling in my fingers goes away eventually... I know it's because my pulse is constantly at 50 and that isn't healthy. I have no other side effects, but then again I haven't tried working out again yet.

    I'm going to be especially worried if my body doesn't adapt and raise my pulse to at least 60 by this weekend.

     
    Old 03-01-2011, 12:28 AM   #21
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    Re: Significant Pulse Decrease with Atenolol

    I found a video that says I should contact a doctor if atenolol puts my heart rate below 60bpm... getting worried

    Last edited by mikevm; 03-01-2011 at 12:29 AM.

     
    Old 03-01-2011, 10:25 AM   #22
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    Re: Significant Pulse Decrease with Atenolol

    Not a doc, but my resting pulse has been low 50s for 8 yrs on beta blockers...Actually has been lower than that at times when Ive increased the dose.

    Last edited by atengnr; 03-01-2011 at 09:01 PM.

     
    Old 03-01-2011, 05:37 PM   #23
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    Re: Significant Pulse Decrease with Atenolol

    have you experienced weight gain?
    it's going to be tough for me to do productive fat-burning cardio if my heart rate isn't budging past 70.

    I'm 21 years old so my target heart rate for exercise should be 199. if I'm not even going to reach half of that, won't I become overweight quickly even if I eat healthy?

    not going to accept that lifestyle change.

    Last edited by mikevm; 03-01-2011 at 05:38 PM.

     
    Old 03-01-2011, 07:37 PM   #24
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    Re: Significant Pulse Decrease with Atenolol

    Go for a jog for 45 minutes. Your heart rate will be well over 100.

     
    Old 03-01-2011, 08:55 PM   #25
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    Re: Significant Pulse Decrease with Atenolol

    I would guess that your max HR is somewhere around 150 with the the dose you are taking. Just a rough guess.

    Yes, beta blockers can cause weight gain, though its quite arguable how much.

    These are some of the reasons that beta blockers are not the preferred 1st line agents anymore. Thiazides, ace inhibitors and ARBs should come first unless you have a compelling indication for a beta blocker (if you just have hypertension, you dont have a compelling indication).

    carvedilol or bystolic would be better choices if you find that you like beta blockers.

    Last edited by atengnr; 03-01-2011 at 09:00 PM.

     
    Old 03-02-2011, 11:46 AM   #26
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    Re: Significant Pulse Decrease with Atenolol

    well the internist gave me this because he said I have some anxiety too.

    but just because my pulse is 140 every time I go to his office, doesn't mean I have general anxiety. white-coat hypertension is much different than anxiety in daily life. maybe I have a LITTLE anxiety like every other college student, but I don't think it calls for reducing my pulse THIS much. as I said, my pulse ranged between 80 and 100 at home before taking this. a 30-50 point drop is pretty significant. I have a history of heart attacks in my family and I don't think that toying with my pulse is the best idea. if you want to give me a med that will put it in the 70s range, then fine. but why limit my body's capabilities this much? I'm too young to have the pulse rate of a senior citizen.

    I guess I have no choice but to keep taking atenolol until I see a cardiologist on Friday. hopefully he'll provide a better alternative.

    I really can't deal with an inability to lose weight. I haven't been able to work out in a month due to the respiratory infection that lasted from 2/1 to 2/15 and BP scares since then, so I already gained 5lbs from that. dealing with another 5-10 because of this medication is another thing, but if it's impossible to shed those 10-15lbs or any weight at all for the rest of my month, this will be an issue. I guess I'll see.

    also, atenolol's effectiveness seems to be wearing off slightly for some reason. my diastolic remains consistently low, between 65 and 75, but my systolic can range anywhere from 115 to 145 even while being on the medication. it was 135/71 this morning. prior to taking this medication, it was typically 124/80 in the morning. I'd much prefer the higher diastolic than have my pulse at an unhealthy level to the point where I eat 2000 calories a day and still gain weight. also, my pulse consistently ranges from 47 to 55. absurdly frustrating.

    I can't find anything that works well. this is so frustrating... I just want a med that works for me.

    lisinopril does absolutely nothing to me, hydrochlorothiazide raises my resting pulse to 120 and exhausts me, norvasac is useless, and atenolol decreases my pulse to unhealthy levels and makes my BP erratic. it would be nice if I could either be diagnosed correctly or given meds that work.

    Last edited by mikevm; 03-02-2011 at 03:24 PM.

     
    Old 03-02-2011, 03:27 PM   #27
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    Re: Significant Pulse Decrease with Atenolol

    so I ran 2.5 miles today with a steady pace of about 7.5mph. this was a typical work-out for me.

    surprisingly, I noticed no loss of endurance. granted, I took it a bit easier than usual, but I never felt an urge to stop or felt weak at any point. I heard leg swelling is a side-effect, but fortunately my legs felt fine. definitely made sure to stretch prior though.

    here's the only odd thing: isn't your BP supposed to be lower immediately after working out? I finished up at the gym and went back upstairs, rested for 5 minutes, and then took my BP. surprisingly, it was 150/90! that's pretty bad immediately after working out, right?

    perhaps more importantly, my pulse at 108 at that point. but I'm sure if I checked it right after I finished running it would have been 130-140, which is good enough to burn fat, no?

    anyways, thanks for the advice. I'll see where this takes me.

     
    Old 03-02-2011, 03:31 PM   #28
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    Re: Significant Pulse Decrease with Atenolol

    What about ARBs? These may have about the fewest side effects on average.

    How long did you take lisinopril for? Id give it a few weeks for full effect.

    did you try diltiazem or verapamil (other CCBs with differing mech of action than norvasc)??

    Beta blockers are sort of the last of the 1st line drugs to be on.

    I reasonable order might be:

    HCTZ - you ruled this out
    lisinopril - did you take it for long enough? what dose?
    ARBs (losartan, atacand, etc) - often well-tolerated
    CCBs - diltiazem, verapamil are options

    Last edited by atengnr; 03-02-2011 at 03:31 PM.

     
    Old 03-02-2011, 03:35 PM   #29
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    Re: Significant Pulse Decrease with Atenolol

    well, at submaximal exercise, you shouldnt have much of a loss with beta blockers (especially at low dose).

    BP goes up during exercise as far as I know. definitely got to wait a while afterwards to get your resting bp again.

     
    Old 03-02-2011, 03:41 PM   #30
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    Re: Significant Pulse Decrease with Atenolol

    I took lisinopril 5mg for 2 weeks, no results. it was the first BP med I ever took. upped the dose to 10mg for another 2 weeks. still no results, and I felt generally exhausted and depressed. so overall, it was about 4 weeks before I stopped taking it. reading the side effects some people have on it, I was fearful of depression and such. it was giving me lots of anxiety and I felt extremely weak all the time. my GP gave me HCTZ a week into the lisinopril to take alongside it because there were no initial results. after the HCTZ jumped my resting pulse to 120 (despite drinking plenty of water and potassium), he took me off the HCTZ and substituted it for norvasac. when I was taking lisinopril and norvasac, nothing happened either. I just felt the same apathetic, depressed mood when I was just on lisinopril. more importantly, no change in BP. keep in mind, I am NOT a depressed person.

    despite the decreased pulse, atenolol actually makes me feel myself again. if my pulse can return to normal I'd be golden, I guess. I notice no psychological or physical defects. as I said, the only side-effects are the pulse being too low and occasional tingling in the fingers and toes (which can likely be attributed to the low pulse).

    thanks for the suggestions on the other ones. I will certainly ask the cardiologist about them next Friday. in the next 8 days I will just eat healthy and continue to work out at a reasonable pace. I'll be eating extremely healthy every day 'til then... except for the St. Patty's Day parade this weekend, of course.

     
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