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  1. #1
    Fail Boat crewman
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    Low blood pressure

    Got back from the doc and told him about the tunnel vision and tingling in the hands and arms that happened twice last month during the hard part of my ride.

    He said the my bp and pulse are low for a normal person, but not for a trained athlete (which I am not, just a commuter). BP of 117/59 with a pulse of 58. He said that I needed to increase, just slightly, my salt intake which he said should help the water retention which in turn should stabilize my BP during exertion. In other words eat a handful of pretzels or dilute some Gatorade throughout the day.

    So just remember ladies and gentlemen that the summer is upon us and hydrate properly with electrolytes, potassium, and other good things lest you find yourself blacked out and under a car tire.

    FWIW, I have tried Nuun and Gu electrolyte. I like them both, but Gu has a better flavor and did not upset my stomach. Nuun does not always upset my stomach, but enough that I would go to Gu.

  2. #2
    Faster than yesterday
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    He said the my bp and pulse are low for a normal person, but not for a trained athlete (which I am not, just a commuter). BP of 117/59 with a pulse of 58
    I know this is sacrilege, but I don't think I agree. Neither of those values is significantly outside the normal range of heart rates or blood pressures, at least not enough to say you would have trouble during exercise. Plenty of us, including myself, walk around with pulses at or lower than this, and blood pressures at these levels. If you're not experiencing problems during your day-to-day life, the problem isn't your resting values. Most people with truly chronic low bp's experience orthostatic hypotension.

    How'd this guy diagnose an issue that only exists during hard exercise by looking at you while resting? It's be a much better test to put you on an erg and measure BP's at various work rates. Then, a failure of systolic blood pressure to rise with effort signals an issue. Diastolic rates should be constant, or fall very slightly.

    Problems during exercise can't reliably be diagnosed at rest.

  3. #3
    DON'T PANIC!
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    Quote Originally Posted by tadawdy View Post
    I know this is sacrilege, but I don't think I agree. Neither of those values is significantly outside the normal range of heart rates or blood pressures, at least not enough to say you would have trouble during exercise. Plenty of us, including myself, walk around with pulses at or lower than this, and blood pressures at these levels. If you're not experiencing problems during your day-to-day life, the problem isn't your resting values. Most people with truly chronic low bp's experience orthostatic hypotension.
    HR under 60 is Bradycardia and is abnormal although perfectly harmless in athletes without other symptoms. An increase in salt intake with low bp and low hr is probably not an unwise direction to take unless there are more severe symptoms.

    That said tunnel vision and hand tingles could just as easily been low glucose as low bp and OP should not let new or continuing symptoms go unchecked as this first diagnosis leaves a little to be desired.
    Weight (April 2010) 200lb -> Goal (Nov 2010) 145lb Achieved -> (Aug 2011) 132lb 10%BF

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  4. #4
    Fail Boat crewman
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    He stated that my tunnel vision etc, could have been caused by a drop in BP due to exertion of exercise and decreased salt, or increased water (which flushes what salt you have out). Since in the 6 or 7 months of commuting it has only happened twice. EKG was normal and he is just being careful to make sure that my heart is ok. He does not believe that it is a heart related issue given my family history etc.. He is just being careful. If it was happening with more frequency he would be more aggressive.

    I don't consider it an issue for me considering its frequency. I pushed through the ten miles to get home when I found myself in that condition.

    BTW - Tadawdy according the American Heart Association low blood pressure is not a "condition" as high blood pressure is. There is only an accepted max BP before you get into high blood pressure. The AHA goes on to say that you should only worry about your BP if you are experiencing the problems that I experienced. Also my doctor is not the kind to order a stress test for something that happens rarely. If the frequency were higher I suspect he would order a stress test. Yes I agree with you about diagnosing a stress condition at rest. That is why he suggested that I keep my electrolytes up slightly to help balance my BP and then if it starts happening with greater frequency I should consult him further.

  5. #5
    Allez means go. bengreen79's Avatar
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    I've had that happen. It is dehydration. I went out for a ride after an evening of enjoying many adult beverages. My BP is lower than yours so I have to be similarly cautious to ensure I'm not dehydrated before going out on a ride.

    If you're feeling it while you're riding, it's too late. I would recommend pulling over somewhere like a park to regain your composure, drinking your water, and then slowly make your way to the nearest restaurant and order a small salty snack and a pitcher of water.

  6. #6
    Faster than yesterday
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    He stated that my tunnel vision etc, could have been caused by a drop in BP due to exertion of exercise and decreased salt, or increased water (which flushes what salt you have out).
    Like I said, your BP isn't supposed to drop during exercise. It isn't unreasonable to see if staying hydrated helps.

    Tadawdy according the American Heart Association low blood pressure is not a "condition" as high blood pressure is.
    Right. It's not a problem unless it's a problem.

    EKG was normal
    Resting EKG is of limited value. Resting blood pressure is not a way of evaluating cardiac response to exercise. Problems at rest could be contraindications to exercise, but the absence of problems at rest doesn't mean a thing in regard to exercise.

    I'm not saying you have some huge problem. I was just saying that if the doc actually thought someone had a drop in BP during exercise (abnormal), dismissing it based on resting measures is really just a way to placate someone. GP's do it all the time (especially in younger patients) and they are right the great majority of the time.

    I can, however, imagine scenarios in which a bike commuter could have a sudden drop in BP. Combine high heat with poor hydration (common in the morning) and a sudden stop in effort (like at a light), and you could have blood pooling leading to syncope.

  7. #7
    Fail Boat crewman
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    Quote Originally Posted by tadawdy View Post
    I was just saying that if the doc actually thought someone had a drop in BP during exercise (abnormal), dismissing it based on resting measures is really just a way to placate someone. GP's do it all the time (especially in younger patients) and they are right the great majority of the time.
    I get what you are saying and if either he or I thought it was a huge problem then I would have been more aggressive in asking for treatment and/or second opinion if he disagreed with me.

    As it is he is going to give me a heart monitor to wear for 30 days so that if it happens again it can be recorded.

    My intent was just to warn people that they really need to be mindful of the salt and potassium intake.

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