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Symptoms of low blood pressure while climbing?

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Symptoms of low blood pressure while climbing?

Old 09-01-18, 04:12 AM
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3949dxer
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Symptoms of low blood pressure while climbing?

I'm not quite sure how to phrase and ask this but will try my best. Please note: I'm not looking for medical advice -- I mainly want to know of others have experienced something similar.

I'm 65 and have been on blood pressure meds for a few years. Things have been pretty consistent, my numbers have been good. Recently I've improved my diet and dropped a few pounds (though I was only about 10 pounds overweight anyway). Meanwhile one of the meds I had been on (Valsartan) was recalled so my cardio switched me to Benicar. My BP actually got too low after that (systolic of 95 at times, which was causing dizziness) so she had me reduce the dose.

That brought me up to about 105 which was comfortable, but lately it's started creeping down again. Today I did a fairly strenuous climb that I've done about 10 times in the last few years. Less than an hour into the steep part I found myself feeling really winded, achy, and generally weak. I was constantly stopping to rest and catch my breath. It was just too much, so I turned back at the halfway point, after climbing about 1900'. It seemed really odd, because I feel like lately, up till today, I've been in my best condition, endurance wise. I've been breaking a lot of personal records on Strava lately and have been faster than ever before.

I also noticed that when I stopped to sit and rest, I felt really dizzy upon standing up.

The symptoms felt almost exactly like I used to feel when doing high altitude hikes. (I used to do a lot of trekking in the Himalayas, at times getting up to 15,000 or even 17,000 feet.) So this makes me think that my body simply wasn't getting enough oxygen, because my blood pressure had gotten too low.

I will contact my cardio soon to see what she recommends. In the meantime I think I'll try taking my meds later in the day, after doing a big ride, rather than before, and see if anything changes.

My question for the forum is: Has anyone else experienced these symptoms while doing climbs while on BP meds, or during periods when their BP was on the low side?

Last edited by 3949dxer; 09-01-18 at 05:14 AM.
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Old 09-01-18, 04:27 AM
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Probably best to get a full medical check up to see if there are other factors. Maybe a stress test -- EKG, BP/HR monitoring, etc., during a workout, if possible and affordable. There may be other complications besides the BP med.

I take BP meds -- beta blockers -- only as needed to control migraines/cluster headaches. Since I don't take the med daily I never really get used to the sensation of feeling a bit lethargic. But when I need to take a beta blocker for a severe headache I won't feel like exercising anyway.

The only time I check my BP and HR routinely is during indoor trainer workouts, particularly intervals. If I'm doing HIIT I check my BP/HR every 5 minutes. I just use an upper arm cuff or wrist cuff, no special gadgets.

I've noticed a pattern in my blood pressure and heart rate. Almost immediately after starting a workout my numbers climb and begin to get rather high after I start the high intensity intervals (repeated sequences of 15 second to 60 seconds of maximum effort, depending on my goals). My BP may rise to 140/70 to 160/80, but the diastolic pressure usually stays fairly normal.

As I warm up and after the first or second sequence of interval reps, the BP settles down to more or less normal. Then immediately after the cool down of 5-10 minutes and resting my BP may drop to 80/50 for 5-10 minutes before settling back to normal.

I do get dizzy during HIIT sessions, but I can't attribute that specifically to blood pressure. I'm also struggling for air. And I discovered fairly recently I have some semi-serious health issues -- a thyroid that's pretty much non-functional, and so swollen it has distorted and constricted my airway and throat, so I have difficult getting enough air during maximum efforts, and difficulty swallowing.

So a few months ago I might have mistakenly attributed my struggles to improve climbing on the road, and occasional dizziness and BP fluctuations to the wrong thing. As it turns out the problems are most likely due to the wonky thyroid. I'm back on thyroid meds (another doctor took me off them, which in retrospect makes no sense). And I'm getting scheduled for surgery to correct the thyroid and trachea/esophagus issues. Probably be several months to a year before I'll know whether or how much difference it makes.

The perils of self-diagnosis.
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Old 09-01-18, 05:00 AM
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Thanks for the reply. Actually my cardio gave me a stress test about 2 weeks ago when she changed the meds. She said everything looked great.

I've noticed similar patterns as you when exercising, I think that's pretty normal, though I've never gotten down to 80/x.

Sorry to hear about your thyroid issue. I hope the surgery is successful, I think it will be.

I think the med changes plus getting into better shape explains my lower numbers, and that it will probably turn out to be a good thing. Maybe this means I can cut further back on the meds or even stop them entirely before too long. I'll soon find out what she has to say about that. If nothing else, my old clothes fit now.
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Old 09-01-18, 11:25 AM
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3949dxer, I have been dealing with the same thing for the past year. When Valsartin was recalled my doc put on on something else that I cannot recall the name of, and it has made a big difference. On a group ride about a month or so ago I was pulling hard on a hill and was hit by an inability to get any oxygen. Was gulping for air and felt like I was suffocating.With the new stuff I don't have this problem. I will say my BP is higher than it was on Valsartin, but is not oppressively high and is right at the High-Normal level. I do believe the difference is how low Valsartin was taking my BP. Was on Valsartin for 4 years.
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Old 09-01-18, 01:18 PM
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How high was your BP before starting the meds? Family History? Other risk factors?

Hitting around 110 Systolic sounds awfully low.

I think there is a lot of controversy about the appropriate cutoffs... with 130 to 150 systolic being borderline, and 80 to 90 diastolic being borderline.
https://www.webmd.com/hypertension-h...icans-off-meds

I increased my cycling over the last 4 years or so... A LOT. Also cut out coffee. Not sure about other diet changes.

I believe my average HR has dropped by about 10 BPM, and both my systolic and diastolic pressures have dropped by about 10 mm Hg.

It is possible that if you increased your exercise, the need for BP meds would change.
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Old 09-01-18, 03:46 PM
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Yes low BP has caused dizziness for me. Usually happens after a climb while resting.
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Old 09-01-18, 05:03 PM
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When I was taking blood pressure meds I experienced the same thing as you. I felt really bad in the middle of a ride and had difficulty breathing. When I got home my blood pressure was 85/50. What I was told is that exercise expands your blood vessels which lowers your pressure. Also as you get dehydrated your blood volume decreases which also lowers pressure.
Instarted taking meds in the evening and that solved problem.
I now no longer take BP meds and if I get real dehydrated I will get light headed so I know pressure must be low. I make sure to get plent6 of sodium and drink plenty
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Old 09-01-18, 05:42 PM
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I don't know the answer but I have similar questions. My BP has been borderline for years but then "they" dropped the targets and suddenly I am over. My Dr. put me on medicine a couple of weeks before RAGBRAI. The first day I was doing the gravel loop which was more nearly sand than gravel and temperatures were in the mid 80s, which is not my best range for performance. I did fine the first half and then nearly died in the last half which became quite hilly. I don't know how many of those hills I walked but it was quite a few. I was nearly spent when I finally got back to the paved part of the route and would have taken the SAG wagon in a heartbeat if it had happened by. But it did not. I made the next town and recovered enough to try for the next after some food and drink and rest. Repeated that for the next two towns feeling a little better on leaving each and finally rolled into the overnight town feeling pretty normal.

So, were the heat, sand, and hills just that bad? Or did my Lisinopril have anything to do with that? A question for my doctor next time I see him.
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Old 09-01-18, 09:18 PM
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No expert here but Benicar is an ARB, the mechanism being one that accomplishes the same thing as ACE drugs-- i.e., chemicals in the body that tighten the blood vessels are blocked (or inhibited). The end result is that 'relaxed' blood vessels lower BP... allowing more not less blood to flow so more not less oxygen is supplied to the organs.

I hope that is the way it works-- I too take an ARB. Just a thought but, you may be experiencing something related more to heart rate than BP.
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Old 09-03-18, 02:31 PM
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I haven't been on meds since a while after my heart surgery. I was dizzy and holding onto something when I stood up. The doc took me off the meds and my wife has pretty well plant based Whole Foods. I still get dizzy if I stand up too quickly but no on the bike symptoms.
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Old 09-04-18, 02:56 PM
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l also experienced low BP while riding in high heat and humidity.I became winded,light headed and weak.BP reading 97/67 when at home about 40 mins. after the ride.The BP rose 5 points every 45 mins.I looked up side effects of my med.Avoid exercise in heat,may cause dehydration which may lead to low blood pressure and electrolytes.So now I know too bad my doctor never thought to inform me.
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Old 09-04-18, 09:42 PM
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The thing that crosses my mind is not so much BP, but heart rate.
I wonder if your heart rate isn't coming up enough for the level of exertion.
And if it just started with the change in BP med.. worth looking into.
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Old 09-04-18, 09:59 PM
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Originally Posted by khutch View Post

So, were the heat, sand, and hills just that bad? Or did my Lisinopril have anything to do with that? A question for my doctor next time I see him.
I take 5mg of Lisinopril. Have been on it for several years. When I was taking 10mg I would have episodes of dizziness, tunnel vision, weakness, low bp during exercise.
After lowering the dose I've been fine. My experience with the stuff is that it sort of puts a limit on heart rate. I have to go really hard to get above 130bpm. I am 65 though.
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Old 09-05-18, 11:27 AM
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Originally Posted by CO_Steve View Post
I take 5mg of Lisinopril. Have been on it for several years. When I was taking 10mg I would have episodes of dizziness, tunnel vision, weakness, low bp during exercise.
After lowering the dose I've been fine. My experience with the stuff is that it sort of puts a limit on heart rate. I have to go really hard to get above 130bpm. I am 65 though.
I believe I am on 10mg! I have not had those symptoms however except for weakness perhaps but I also know I have not trained well this year compared to other recent years so I am not sure I can blame the drug. Curiously my heart rate monitor has not worked since I started on the Lisinopril ... coincidence?? Yeah, probably.
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Old 09-05-18, 01:10 PM
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They put me on blood pressure medicine Coreg a few weeks ago after heart failure and stent placement. I was getting dizzy and weak because of low blood pressure until i passed out twice when my bp dropped to around 70/35, so i stopped taking it on my own. The cardiologist still says to take it but i won't. I also take low dosage Lisinopril 2.5mg which i may decide to stop as well.

My blood pressure now is usually between 95/48 to 118/65 on its own even without Lisinoril but it used to be very high before for years and i took bp medication. A few weeks before i was diagnosed for having congestive heart failure and diabetes i completely cut sugars and white flour from my diet and added a lot of veggies and my bp dropped to current normal levels in no time. I did this because i was having shortness of breath when walking or riding and thought i was getting old (i'm 60). Turns out the shortness of breath was caused by liquid in my lungs which in turn was caused by heart failure.
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Old 09-05-18, 03:55 PM
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I've experienced similar issues as you describe. In fact it happened just this morning while I was hiking. Although not cycling, I hike pretty hard so it is a good physical workout like cycling.

I'm currently on 100mg of a Cozaar generic equiv. for HBP and have been since Feb. I let myself gain a lot of weight and got terribly out of shape which made my BP go sky high so the Dr. put me on BP meds which seem to work pretty well. In an effort to get off the meds I decided to lose weight and get back into shape so I started hiking back in April in preparation to eventually get back on my bike. Things have been going well as I've lost quite a bit of weight and am now in relatively good shape for a 63 year old that still has some weight to loose.

But a maybe 3 times now I've gone out for my daily hike and during the workout I've felt light headed and weak. At first I didn't connect my BP to this but eventually I figured it out.

On my hike there is about a 1 mile stretch with 500' elevation gain. Initially I struggled some and had to take it slow to get up the hill. But over time I've gotten to the point I go right up about as fast as I can walk no problem which gives me a good cardio workout. But not today. I had to stop probably 8 times and rest for a couple of minutes and felt light headed. After I finally made it back to the car I came home and checked my BP and sure enough it was down to 75/54 at least 30 minutes after the hike. My BP normally has been running in the 105/70 to 95/60 range after I hike and I feel great. And like you I feel I'm in the best shape I've been for a long time and routinely break my personal records.

I knew something was wrong in the parking lot before the hike though. Since I wear a HR monitor when I hike I noticed my pulse was at 73 standing by the car getting ready for the hike. It normally would be closer to 60. And when I started the hike my pulse was probably 10-20 BPM higher than it normally is in the flat and gentle up hill areas and only got higher in the more strenuous sections.

I think I will dial back the meds to 50mg/day or maybe just stop them for a few days and see where my BP is.
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Old 09-06-18, 09:32 AM
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Originally Posted by August West View Post
I...

BP and sure enough it was down to 75/54 at least 30 minutes after the hike....
Google it! This reading is apparently... a sure sign you need to have your BP machine checked out.
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Old 09-09-18, 02:00 PM
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Saw my doctor on Friday asked for a BP medicine that would not lower my BP to the point Iím weak in the heat.He said itís not the medicine I take thatís the problem.He wants me to not ride in the high heat of the day.People come in with the same symptoms exercising in heat who are not on BP meds.Temperature dropped a good 20 degrees this weekend rode and no change in BP after the ride.
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Old 09-13-18, 02:44 PM
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i completely blacked out riding a few times....needed a pacemaker
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Old 09-14-18, 02:10 PM
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I lost a bunch of weight and didn't realize I needed to reduce my BP meds because it had been elevated for so many years even before I put most of the weight on. I didn't feel symptoms like that while working out, but I sure did when I was standing up from a chair or couch. Turned out my BP was getting down to crazy low numbers like 68/48. It is definitely not pleasant. Especially because I was too large a dose of atenolol, and my pulse rate was getting down in the 40s. I'm off that now and just take the smallest dose of lisinoprol there is.

If it's possible, get your BP right after a tough ride--go to a drug store and use their machine if you have to. Do this a few times to see if you get a pattern, and you might also want to do it under other circumstances for a baseline.
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Old 09-14-18, 04:55 PM
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Are you sure you're well enough hydrated?
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Old 09-18-18, 06:12 PM
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Take a BP machine with you and check your BP if you start feeling weak. That should tell part of the story. Also when you start to dehydrate your BP will likely drop some.

Just remember when the BP hits zero it is game over.
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Old 09-21-18, 10:48 PM
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Live long and prosper...


Myth: Low blood pressure (hypotension) is as bad as high blood pressure
Truth: Low blood pressure is often referred to as hypotension; a classic blood pressure reading would be 100/60 mmHg. People with low blood pressure tend to live longer than those with normal and high blood pressure, but do tend to suffer from side effects such as light headedness when standing to quickly (postural hypotension).
Positive Health Online | Article - Exercise and Fitness: Blood Pressure: Truths and Myths
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Old 09-24-18, 05:28 PM
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Symptoms of low blood pressure while climbing

I have used Benicar 40mg for years with no problems but if BP gets above 140 systolic I add HCTZ. I do a lot of riding in the mountains and a few years ago while on HCTZ I just ran out of gas after a 25 mile climb. I couldn't even turn the pedals. When they got me to an ER my BP was around 99/40 so my guess is probably 80 something over 40's when I stopped. I can do a fast training ride with groups but once extended climbing is underway I get weak so I don't ever use HCTZ if I am doing a climbing ride. After a hard ride my resting BP is usually around 110/52 so I suspect yours drops also. You can probably get the Doc to give you 20mg Benicar and cut it in half if you take it before your ride.
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Old 09-24-18, 09:58 PM
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Originally Posted by fastcarbon View Post
I...


After a hard ride my resting BP is usually around 110/52 so I suspect yours drops also. You can probably get the Doc to give you 20mg Benicar and cut it in half if you take it before your ride.
Not a doctor but... I don't think the recommended biologically-effective dosage to treat elevated BP is something you fail to take on a regular schedule. Interesting though... Benicar is a trade name for one of 7 or so ARBs and in a 2008 study these drugs apparently were found to be effective in helping to prevent Alzheimer's disease.


A retrospective analysis of five million patient records with the US Department of Veterans Affairs system found different types of commonly used antihypertensive medications had very different AD outcomes. Those patients taking angiotensin receptor blockers (ARBs) were 35Ė40% less likely to develop AD than those using other antihypertensives
https://en.wikipedia.org/wiki/Angiot...ceptor_blocker
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