Training & Nutrition - Impact of Beta Blocker Medication

About a week ago, I was diagnosed with an exercise-induced irregular heartbeat. Although my heart itself is OK, apparently one of the valves (I forget which one) is defective and starts acting up when my heart rate goes up, causing the irregular beating. The stress test showed little issue at rest, but mild irregularities happen when I increase my heart rate from rest, and then the irregularities feel uncomfortable once my heart rate goes above 170. I'm 37 years old, so my theoretical max heart rate is 183 according to the 220-age formula (which I know doesn't work for all people, and I know when I was younger I could go 10 higher than the formula would indicate).

The cardiologist prescribed a beta blocker (atenolol), which I have been taking for about a week now. I've been doing some research, and I've noticed that this medication is usually prescribed to patients with high blood pressure. From what I've seen it lowers the heart rate. But if that's all that the beta blocker is going to do for me, then why can't I just ditch the beta blocker and just use a heart rate monitor to keep my heart rate below 170? Plus I wouldn't have to deal with the side effects of the beta blockers.

Also, I live at sea level but have a weekend cabin in the mountains (6000'-8000' elevation). I'm disturbed from reading some of the studies I've seen about the impact of beta blockers on exercise at higher elevations, particularly since I don't live at elevation full-time.

What does your doctor say about it?

I'm gonna ask him, but he's out of town until Wednesday. I get the impression that most of his experience is with inactive patients, though. I may seek a second opinion from a doc who deals with more active patients.

This might be a moot point, since the doc said he'd switch me to something else if my heart rate dropped below 50. Since taking the medication, my resting heart rate in the afternoon has dropped from 58 to 48. The resting heart rate after I wake up will probably be lower, I'll have to check with the heart rate monitor.

I wonder if you would be interested in my experiences with Atenolol. Of course, you realize that this is just me, and not a typical experience for other people who take it. But it is related to my experiences with cycling, so maybe others will be interested.

Like you said, Atenolol and other beta blockers are prescribed to lower blood pressure, and also to regulate the heart's rhythm. In other words, it can fix an irregular heartbeat. It sounds like that's why your doctor wanted you to try it. It also reduces risk of second heart attacks, and that's why I took it.

I took atenolol (Tenormin) for about four years. Sometimes my resting heart rate would get quite low, like 42 bpm. My exercize heart rate was low too--it was almost impossible for me to hit target heart rates even with very vigorous exercize. A year ago I fell off my bike and got hurt real bad. I went home after the fall and a few hours later I passed out. My roommate had to call an ambulance, and I was in the hospital for two nights. My blood pressure and heart rate were both dangerously low and were not coming back up. My doctor eventually decided that I had not only gone into psychogenic shock, or "fainted" from the pain, blood loss and trauma. He thought the Atenolol was also making it difficult for my BP and HR to return to normal. He took me off the Atenolol and has never resumed it. In fact, he wondered if the Atenolol even caused my accident -- maybe I actually passed out while I was riding, and that's why I fell. I really doubt if this was true, as I recall riding strong and fast right up to the time I fell. But I do know that I got lightheaded and dizzy three times in the four years I was taking Atenolol.

I hope my experience doesn't scare you off of the atenolol. Obviously, there is a reason that your doctor wants you to take it, and it would probably not be good to stop without checking first. I think you are right to talk this over more with your doctor, and to get a second opinion if he doesn't understand your concerns about interactions between medicine and your active lifestyle.

The main reason I wrote such a long post is so that you will be careful when you are cycling while on this medicine. Stop riding right away if you feel lightheaded, fatigued, confused or short of breath. Low BP and/or HR can result in less blood flow to the brain, and that can't be good when you are spinning along.

I suggest asking your doctor if there is any danger with the irregular heartbeat. If it's just a nuisance that feels wierd, then perhaps you can do without the medication. But you certainly need to ask you doctor since he knows the details on your condition.

I started taking a Beta Blocker about 8 months ago to try to prevent migraine headaches.

I started off on a small dose (20-40mg nadolol) and I was going to spinning classes (almost every day) same as I was before I started on the Beta blocker. As you know spinning can really get you worked up if you go at it hard (like I do at least).

I wasn't too bothered by the lowering of my HR. I have a very high max HR (off the charts higher than the formula and I have been tested plenty) so maybe that is why I didn't notice the effect too much.

The medication did make me feel sleepy, but taking it in the evening negated most of that effect although it did not help me sleep in fact it seems harder to get to sleep on the stuff.

The worst side effect I noticed was feeling cold and getting cold hands and feet (in the winter, in summer it's not a problem).

One of the main side effects that men don't like with beta blockers is that it can cause impotence. Didn't with me but I was at a low dose.

I also get funny irregular heartbeats after hard workouts that can last hours (although nothing irregular showed on the stress tests I took for that very thing). In my case the beta blocker does help take those irregularities away (although that is not why I take it).

I am on other medication to try to prevent the migraines (candestartin) and take a very very low dose of the beta blocker now.

All in all it wasn't too bad for me overall on the low dose, but the freezing part in the winter really sucked.

They (beta blockers) are very effective drugs that have been on the market forever and have proven safe for most people.

Good luck. Hope this helps a bit.

Sorry to leave my day job position and do a late chime in on this important topic but here goes.

I just received an article entitled: "Reducing Heart Rate in Hypertension Is Harmful -- or Is It Just Atenolol?" (http://www.medscape.com/viewarticle/582499?src=mp&spon=18&uac=45626AN)from Medscape Medical News. Of note and listed under Pearls for Practice are these two summarizing comments

"Pearls for Practice

Heart rate lowering with beta-blockers in patients with hypertension is associated with a greater risk for cardiovascular and all-cause mortality.
Heart rate lowering with beta-blockers is associated with an increased risk for heart failure, nonfatal MI, and stroke, with a linear inverse relationship."
But please if Beta Blockers are an issue with you and you are concerned about the health ramifications of Atenelol read the full article and/or print it out and take it to your doctor.

OK back to my day job....

Beta blockers are NOT just a high blood pressure drug. In fact, nowadays, they are probably more important for treating some heart beat irregularities such as yours. You know, you can literally drive yourself into a frenzy of anxiety and medical student syndrome by reading and researching too much. Don't worry about side effects unless you get them. You are almost sure to feel any side effect if you read about it.

Yeah no point in knowing the whole truth. Just a little bit of the whole picture for some.

Some call it 'frenzy' some of us call it knowledge and think it's better to be proactive in our own health care.

You say "Don't worry about side effects unless you get them. You are almost sure to feel any side effect if you read about it."

But note the conclusion is increased mortality. By the time you get that 'side effect' it's a bit too late don't you think.

Sorry to leave my day job position and do a late chime in on this important topic but here goes.

I just received an article entitled: "Reducing Heart Rate in Hypertension Is Harmful -- or Is It Just Atenolol?" (http://www.medscape.com/viewarticle/582499?src=mp&spon=18&uac=45626AN)from Medscape Medical News. Of note and listed under Pearls for Practice are these two summarizing comments

"Pearls for Practice

Heart rate lowering with beta-blockers in patients with hypertension is associated with a greater risk for cardiovascular and all-cause mortality.
Heart rate lowering with beta-blockers is associated with an increased risk for heart failure, nonfatal MI, and stroke, with a linear inverse relationship."
But please if Beta Blockers are an issue with you and you are concerned about the health ramifications of Atenelol read the full article and/or print it out and take it to your doctor.

OK back to my day job....


You have to try to interpret the results properly. They talk of B-Blockers and hypertension; the OP said that he is taking it for irregular heart beat, not hypertension. The problem with atenolol is that it increases central pressure because it does not cause vasodilation.

The pears of wisdom that you posted refer to hypertension and B-blockers, not irregular heartbeats. To quote 2 doctors who analyzed the study.


Senior author Dr Franz Messerli (St Luke's Roosevelt Hospital) told heartwire: "Slowing heart rate is known to prolong life expectancy, and with beta blockers post-MI and in heart failure, the slower you can make the heart rate, the better. But this new paper goes against the grain. What we show is that in hypertension, when you slow down the heart rate with a beta blocker, it actually shortens your life expectancy, it causes more heart attacks, more heart failure, and more strokes." Messerli says he and his team believe the likely explanation for this is "that slowing the heart rate with beta blockers increases the central pressure, and obviously the latter is one of the determinants of stroke and heart attack."

If you read the abstract they say that the purpose of the study was to evaluate the role of heart rate reduction with beta-blockers on the risk of cardiovascular events in patients with hypertension, and not people with irregular heart rate.

The conclusion states:


In contrast to patients with myocardial infarction and heart failure, beta-blocker–associated reduction in heart
rate increased the risk of cardiovascular events and death for hypertensive patients.


Nowhere does it indicate anything in relation to irregular heart beat.

I took it for a while.
Was completely useless as a human.
My heart rate went down to 31 bpm.

I was on this same medication for the treatment of high blood pressure. Every time I tried to jog or get my heart rate up it was an all out effort. You will be fighting the intent of the medication. In addition I found that it made me tired. Spoke with my doctor and he changed my medication to Calcilum Channel Blocker. No more fighting the medication to raised the heart rate. Not sure what other med. would be used for your issue.