Morimorimori

Randonneuring seems to attract a lot of people of older age, so I thought I can get a lot of insights on the subject Long distance rider myself who has been just diagnosed with hypertension (still of unknown origin, and I think I could have it years prior to that already), I now feel quite a bit soul crushed, as cycling has become an important part of my life. Of course it's a question one better asks his medical provider, but many doctors will take a very cautions approach and will just strictly forbid you to over-exertyourself. So I though some experience shared by those who still does long distance riding regardless of their diagnosis may be useful, as well as some hints, recommendations on mediation selection and consumption, monitoring your health during the long ride etc. Also especially interested in experiences of those who kept doing high intensity training and strength training despite being diagnosed - how well it works for you, does it make controlling your blood pressure more difficult, do you need to take stronger medication post-excercies etc.

Just please don't send me to doctor immediately - I'll surely will be getting their opinion as well (planning to pay a visit to athlete-oriented medical clinic at my location). But having different opinions never hurts.

Long story if you need more context (proceed with caution ):

After having covid last autumn and suffering from its post-effects for a few months, I've been undergoing a lot of medical examinations, to find out why I won't get better. My number one complaint was troubles sleeping (which I had prior to that, but it got worse post-covid), and fatigue I attributed to it. As it wasn't hard to fall asleep for me, but I woke up many times during the night for no apparent reason, I suspected I may have either compression of neck arteries or apnea (will test for the later next, as it can cause hypertension on its own). Now I remember that I often felt fatigued after a long ride or hard training session many years before it, but never thought too much of it - you're expected to be tired after some hard work, right? Though interesting is that I almost never felt fatigued during these activities (I usually felt good or wonderful, much better than when sitting at home), there was rapid onset of fatigue in 1-2 hours after I stopped and relaxed. Also my heart rate was never abnormally high, actually my resting rate was notably better (lower) than of average people of my age. I didn't feel sick before, and the sleep disturbances was my main complain, I attributed fatigue I experienced to it and tried to solve it using sleep hygiene approach. Though I was told by doctors I have unusually high BP from time to time, it was something like 130/80, 140/90 occasionally, and I didn't do anything about it.

So one day I thought about measuring my blood pressure 2 hours after HIT training (as I became more aware of my health since covid and bought my own BP measuring device), when I was already relaxed and calm, though felt fatigued - and ended up with numbers from 160/100 to 170/110 consistently, across a dozen of measurements, despite trying to relax in between them with breathing exercises. Again, I didn't feel any pain, my HR was normal, and the only give away was fatigue and may be lack of mental clarity. I slept worse than usual that night again (probably due to stress caused by these findings, as I also have anxiety issues), and took another reading in the middle of it - it still was the same high number. Then it didn't improve next morning at all. So I stopped any hard exercises and went to clinic after a couple days, when I was already rested - it showed 130/80 again. But doctors say such abnormality is enough to start me on meds.

GhostRider62

I have had all that stuff. I also got Covid in the Fall. Same issue as you.

Stop doing HIIT, between Covid and HIIT, your sympathetic nervous system is being overly taxed. Kick back the intensity and duration until you sleep well. Keep it to zone 2.

Sorry if this lacks a lot of detail, I think I know what I am talking about but who knows

unterhausen

Sleep apnea can contribute to high BP. My problem right now is weight, I think, my BP goes up when I weigh too much. Weight also contributes to sleep apnea.

Morimorimori

My weight is ok, may be 5 extra kgs, but that's about it. The main reason I suspect apnea is because of the way my sleep is disturbed. Almost never I have troubles falling asleep - but I'll wake up 3-7 times over the night, with no apparent reason. Sometimes I feel like my heart is beating faster than I would expect for the case when you should be relaxed and sleeping. And on a few rare occasions, especially when I'm sleeping on my back (usually I'm a side sleeper) I'm sort of dip into sleep, then abruptly is kicked out of it while my throat is making a strange "ghhrr" sound.

Morimorimori

What about long distance cycling? Do you have some experience doing it, while taking hypertension medications? How hard is it? Does it affect your abilities as an athlete, like may be you feel much weaker and more susceptible to fatigue while on the meds? This is the question that worries me most atm.. I'll most likely be put on drugs on daily basis soon, does this mean no brevets for me? From now on just a zone 1 short distance cycling?

jlippinbike

The pandemic lifestyle most people were forced into caused them in some cases to get sick, but in most cases to gain weight and lose fitness. I suspect you got the triple wammy: sick, fat, and unfit. Getting past the sickness probably added to the fat level and definitely helped increase the level of unfitness. At that point I'm sure your blood pressure on average went up. To rebuild your fitness you need to eat more healthily, probably eat a little less, and do low intensity aerobic exercise (zone 2). This is how you lose weight and build endurance capacity. The higher endurance ability you have will probably indicate less hypertension. Ideally the zone 2 workouts (probably on the bike) will last at least 3 hours. The body uses fat for fuel when doing low intensity exercise. Only after you have gotten back to a normal weight and on the road to a normal fitness level, it is then that you can add 2 or 3 higher intensity workouts a week. Or if you are over 55 or so, then maybe only 1 high intensity workout a week. Your blood pressure should be fine thereafter. But right now you are obviously doing things backwards. You are starting out with the HIIT stuff. Not good. Last year after a bout with cancer I wasn't too active. My weight went up and my fitness level had tanked. My blood pressure was up to something like 140/20 or 145/20. Six months after doing what I describe herein above my blood pressure was back down to 120/80. My bike rides were a bit longer than 3 hours each, though.

Morimorimori

Thank you for sharing. As I mentioned above, my weight shouldn't be an issue (at worst it's +5kg extra over winter, I'm 86kg right now at 182cm height), and also pandemic was handled quite differently in our region (for worst or for the best, dunno) - we weren't kept at home, no state-mandated working from home etc. And I didn't interrupt my training due to this. I have home trainer on which I spend most of the winter, and I may take up to a month away from bike (still doing some basic zone 1 spinning almost daily, just not training) - but the rest of the time I keep exercising as usual.

As for the blood pressure - I suspect it won't recover that easily. It seems I turned bind eye on its creeping growth over last 5-10 years, when I try to think back. I.e. it was an issue even before COVID - just was easier to ignore, wasn't that severe. So I think it's about time for me to start on meds, to prevent more severe consequences.

jlippinbike

Morimorimori said: I'll most likely be put on drugs on daily basis soon.

I hope you are not like the millions of people out there who blindly take their doctor's advice. Once you start taking a med it is highly unlikely you will ever stop taking it. If you had been diagnosed with hypertension as a youngster, then maybe meds would be the proper solution. However, it sounds like you are a full grown adult and this hypertension has come on through something you have eaten and/or a change in your lifestyle. Taking a med instead of fixing your diet and/or lifestyle is the expensive and lazy way out. Typically it is masking the symptoms and leaving the underlying problem unsolved.

By the way, before I got back on the bike last year I had that "ghhrr" thing you describe in another post. I called it a weeze. It was kind of like a gurgle and sometimes a sort of whistle. After about a month or less of doing zone 2 three-hour+ bike rides that weeze disappeared. My biggest problem last year was my HDL to Triglycerides Ratio which was 3.7. Is yours high at present? The doctor wanted to put me on statins. I'm currently age 60. I told him I don't do meds. He told me I might want to consult a dietician and up my workout routine. He would not advise me on how to eat. I knew what I needed to do. So I ramped up my zone 2 bike rides, improved my diet, and practiced intermittent fasting. The first 3 hours of any bike ride was in a fasted state. If the rides were flat, then the whole ride often times a done totally fasted. An acceptable HDL/T ratio supposedly is 2.0. When I went back to see the doctor my ratio was 1.0. The doctor was shocked I changed my blood work in only 6 months. He wanted to know exactly how I did it. Since he was vague in giving me advice I was vague in my response to me. Tit for tat!

GhostRider62

I was on hypertension meds for maybe 10 days. Killed my riding.

I figured out the Docs did not know how to measure BP.

You cannot be cold. Back and legs need to be supported. You have to rest 5-10 minutes before they take a reading. It should take at least 90-120 seconds and the BP cuff has to be the correct size. MOST important, the measurement has to be taken at the same height, gravity wise as the right atrium. If your arms are long like mine, it can be over 15 mm difference and up to 23 mm Hg in the literature. YMMV


https://www.ahajournals.org/doi/full...50859.47929.8e

jlippinbike

Morimorimori said: It seems I turned bind eye on its creeping growth over last 5-10 years, when I try to think back.

Yeah, weight can creep up on you over a 5-10 year span. Blood pressure does the same thing. And the creeping for both is caused by the same thing usually: poor diet and lifestyle changes. Don't forget that as we age we typically lose muscle mass. So our weight gain from fat deposits is usually under reported. Muscle weighs more than fat. So it sounds like you have more "base training" in zone 2 ahead of you to really get a handle on your hypertension. Up those zone 2 workouts, eat better, and practice intermittent fasting. There is not a specific time to see results. Keep plugging away at it and things will turn around.

unterhausen

I am on 3 different bp meds now. I haven't noticed any ill effects at all while exercising. One of them I have to take with at least a little food or it causes stomach upset. The main issue they cause is making sure I have them on long rides. And then when you're up at all hours, deciding when to take them. As old as randonneurs are, I assume many of us are on BP meds.

There is a tipping point on my weight where I have trouble with BP. I think I can eliminate fitness as a factor. So for me, at least, 10kg can make the difference between normal BP and high BP. Heart issues are hereditary for me, I figure I will always be on meds.

downtube42

I was diagnosed at age 55, after a lifetime of cycling but also a lifetime of desk work. My bp, and all other stats, have always been stellar. Still are, except bp. I'd never been on meds before so i resisted. My doc was supportive but warned me not to ignore the numbers because they would cause heart damage over time. I dropped 15 pounds, down to 185 at 6'3". No change in bp. My diet was pretty good already, but i increased fruits and veggies. We signed up for a produce delivery program to ensure a steady supply. No change. I was checking daily, and I did notice a temporary drop after a hard ride. Like for one day, after a hard 40k. So... a hard 40k every other day, maybe?

I also have sleep apnea, treated with a nighttime dental appliance. Probably had it my entire adult life, based on reported snoring and occasional dreams of suffocating. Diagnosed in the same timeframe as high bp.

Eventually i went on meds. I feel like it negatively impacted my performance, but it's not evident from rando results. I've moved from flat Indiana to hot Texas and now to not-flat Oregon, and results reflect those changes. Throw in 7 years of aging, and any results of meds are not distinguishable from the noise.

Doc days keep trying, keep monitoring, and if the medicated bp drops too low, then we wean off the meds. Seems reasonable. I don't like taking those two pills daily.

As far as rando, I'm doing all my work schedule and marriage allows. PBP this year.

That's just my story. I didn't knowingly have COVID, which seems a significant factor for the OP.

I'm a software engineer, not a doctor.

jlippinbike

Downtube42 said: I'm a software engineer, not a doctor.

I read your post, and I have two questions: 1) Is your desk job as a software engineer stressful? You don't mention that in your post. 2) What is the mix of your bike riding outings? You only mentioned higher intensity rides. A lack of zone 2 low intensity rides might be a problem for you.

HIIT workouts can help with stress, but they do not help much with endurance development. And people who are stressed typically need to improve their endurance ability more than their performance ability. Zone 2 training typically is the solution. HIIT typically can make the problem worse. Stress at work is typically dampened by getting extra sleep at night along with a nice supply of zone 2 training. But you say you have sleep apnea. I've been told at times when I let my fitness level drop that I snore. When I raise my fitness level the snoring goes away. You say both your snoring and hypertension were diagnosed in the same timeframe which very well could mean they are interrelated. You say you don't like meds, but you started using a nighttime dental appliance (a kind of med). It's my hunch based on the facts you have presented that if you solve the snoring problem through lifestyle change of some sort, then I suspect the high bp number will go away.

Fruit and veggies are definitely good for you. However, sugar is a pretty potent drug. And fruit has sugar in it. Sugar intake, and that includes the sugar in fruits, should be consumed in moderation. Sugar may be affecting your hypertension, too. You may want to try cutting ALL sugar from your diet and see if your blood pressure goes down. I suspect it is worth try since you say you don't like "those two pills." Good luck!

downtube42

Stressful in a first world sort of way, so basically political bs which i can keep into perspective.

I commute, ride utility miles, ride non competitive sporting rides, and ride brevets. HIT either indoor or outdoor, when ramping up for an event. Tons of Z2 miles.

OP asked for experiences, which I shared. I'm not looking for medical advice on bf, even from doctors on bf. I expect any doctors on bf would refrain from giving medical advice.

jlippinbike

DownTube42 said: I'm not looking for medical advice on bf, even from doctors on bf.

Per a Wiki post: Medical advice is the provision of a formal professional opinion regarding what a specific individual should or should not do to restore or preserve health. Typically, medical advice involves giving a diagnosis and/or prescribing a treatment for medical condition. See https://en.wikipedia.org/wiki/Medical_advice

What I wrote was not a Formal Professional Opinion. Nor did it amount to a diagnosis or even go as far as to prescribe a treatment for a medical condition. All I did was analyze the facts provided and try to make sense out of those facts. But if you take offense, then I apologize.

Bearhawker

How's your blood sugar?

Salt is the thing most often heard as the culprit for HBP, but you almost never hear about sugar.

The discussion about salt is that salt and water molecules bind (where sat goes, it takes water with it), so removing salt will remove water, reducing the blood volume.

Salt/water bind 1:1

Sugar also binds to water but at 1:6 - six times more than salt.

Good luck and I hope you get a result that works for you!

blacknbluebikes 

I changed to a cardiologist who is also an endurance exercise practitioner. I've been through a lot of doctors, way outside the norm. I talk a lot about "medical arts" versus "medical science", and I feel that unless one's conditions fall right on a known, regular profile of commonly seen illnesses, then we are talking the "arts" side of the coin - and the possible treatment/therapies become diverse. So, it's in your best interest, if you want to be on the bike, to find a doctor that personally engages (read:believes) in regular endurance exercise. My cardio guy is a big runner, and he believes that I should be on the bike. Never suggests that I should be pushing zone6 HR all day, but does think a 100 mile week is quite 'regular' for people who are willing to build it up reasonably and maintain it. My height is 71cm and my weight is 70kg, while long ago in the past it was as high as 84kg. I'd bet you can lose quite a bit if you decide that's worthwhile. (I like it better, for sure). 130/80, as you mention, doesn't get you into the BP hall of fame.

antimonysarah

I have (so far) fairly mild hypertension, am on a small medication dose. (The one I take can drop potassium levels and is a diuretic, so my doc recommended being good about electrolytes while riding and has regularly checked my levels, but I haven't had that issue with it.) I was doing long distance before it and my doc didn't recommend any changes to my training or riding. I never had any symptoms and still haven't.

Chris Pringle

I also have mild hypertension. I was diagnosed briefly in my early 30’s but kept it at bay for a couple of decades through diet, weight control and exercise. I successfully completed PBP in 2015.

I noticed again a significant increase in BP after taking Covid vaccinations. I saw a cardiologist about year and half ago. He recommended cardio exercise 30 minutes a day and to get rid of 10-15 lb. of excess weight - basically, 190 lb down to 175 lb which I am working on. I take a very small dosage (half of a 50 mg Losartan tablet) only as necessary. The main BP reading for me is before bed - if it creeps up to over 130/80, I take my half tablet. This is mainly to avoid any spikes at night when sleeping as most heart attacks happen between 3-6 AM. The medicine (whenever I take it) has not affected at all my exercises or lifestyle. But the days I exercise, my BP normally stays within the normal range without meds. But one sedentary day and it creeps up again which is upsetting.

@Morimorimori: in your particular case, my recommendation is to seriously look into your sleeping. Waking up several times at night with a certain panic/anxiety is not normal. Yes, sleep apnea is a suspect but it could be something else like an enlarged uvula or even a deviated septum. A sleep study is in order which, as you may know, can now be conducted at home. Sleeping disorders are known factors for cardiovascular disease usually in the form of hypertension. I sleep with an Apple Watch to monitor my sleeping patterns and quality.

In regard to ultra sports, including brevets, I think that they are too hard on the body. Just keep exercising moderately. There’s no need to overdo it while you get to the bottom of your situation and understand the limits. Once it’s under control, start increasing your distance little by little under constant monitoring before and after.

Oh, one thing I discovered recently on a vacation trip is that a hot/wet sauna at least an hour before bed drastically lowers my BP. Maybe a hot tub or even a hot shower before bed might help you.