# Blood pressure, meds and riding



## Revolver1529 (Oct 5, 2009)

Hey all, I'll be 50 next week and my blood pressure recently has gotten higher (>150s/100s). It's been borderline high (140/90) for years but I hoped I could "fix it by riding, because riding is cheaper than meds" but apparently that's not the case. I asked the doc to give something that won't effect my ability to ride, train and race. He prescribed lisinopril and after a month it clearly wasn't that effective for me and on top of that I developed a nasty dry cough, mostly at night. Yesterday he prescribed something else, amlodipine, which is a calcium channel blocker and is also supposed to be a good choice for athletes with high blood pressure. Hopefully that's the ticket to get this under control.

So my question is, does anybody have any experience with BP meds that have been helpful or harmful to your riding? I've read that some meds effect your HR and stroke volume, and some of the first choice drugs such as Thiazide diuretics and beta blockers are a bad choice for athletes. I understand everyone is different and what works for one might not for somebody else but I'm just looking for some anecdotal examples to help me deal with the anxiety I'm feeling over this.

Thanks


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## rzims (Sep 7, 2005)

I was on lisinopril as well and in addition to the dry cough, they really affected my performance. Whenever I'd start climbing, I'd immediately redline and my heart rate would stay high for a long time afterwards...
Dr said there's no way that was the meds, but as soon as I stopped taking them it went away...hmm

For me, dropping a few lbs(10) and riding more did work as far as controlling my BP and as long as I can get in 2x per week, it seems to keep my bp down...

Pretty sure this was no help at all to you but thought I'd share my experience.

Good luck in getting it under control


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## Oh My Sack! (Aug 21, 2006)

I'm 52 and I've been on Losartan and Amlodipine. Amlodipine was added maybe 3-4 months ago to replace Hydrochlorothiazid that my doc thought might be causing an elevated bilirubin count. I've been on a BP med regimen since before I got back into riding so I can't say it has had an effect. I can say going to Amlodipine has not changed anything in my performance. I have my moments where my BP is down in the 120's/80's but I still catch a lot of periods where I'm in the high 130's to 140's. I'm pretty sure I'm hypersensitive to sodium. Could be the same for you. I'm finding it's virtually impossible to get away from, even after eliminating processed foods and watching closely what I intake. I'll be discussing with my doc in another week.


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## Bigb2000 (May 20, 2013)

No cough with lisinopril, but I definitely can feel it on the bike when climbing. Was wondering if that was the cause. Been taking it about 3 months now. Can you follow-up with results on your new meds.


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## Revolver1529 (Oct 5, 2009)

I found this article helpful when talking to my Dr about med choice. Table 4 is quite interesting.

Managing Hypertension in Athletes and Physically Active Patients - American Family Physician


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## Bigb2000 (May 20, 2013)

So the Thiazide shouldn't be taken when riding hard? The article states they less pronounced effects. Either way, many thanks. I'll print and take to my next check-up.


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## -Todd- (Jun 13, 2011)

I was on Metaprolol for a while. I couldn't get my heart rate up to where I needs it to be and it hurt. My legs ached and my buddies all pulled away on the climbs. I took the leap and ditched the meds and worked harder, longer. BP is normal(er) now, and I continue to work on it. Medication is almost as bad as the problem it's trying to solve. I take Cal-Mag before bed every night, it relaxes the system and helps keep things in check.


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## Wherewolf (Jan 17, 2004)

*Benazepril*

I've been on Benazepril for several years and it works quite well, and with no side affects.


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## walangkatapat (Jun 2, 2009)

I got the same cough from Lisinopril, more like coughing convulsions in my case. Ended up on Benicar which lowered my BP with no cough. Dropping 30 lbs did the job for me, no more high BP or meds.


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## Zignzag (Jan 23, 2004)

*metoprolol*

My new doctor started me on metoprolol several months ago. It works by keeping your heart rate low, which is BAD if you're an athlete. I struggle now on hills that were easy before. I have a follow up appointment soon and I'm going to demand another type of meds.

I had no ill effects with amlodipine (Norvasc) but it lost it's effectiveness after 15 years.

There are lots of different types of BP medication.


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## Zignzag (Jan 23, 2004)

Wherewolf, what's the dosage? And how much did it lower your BP?


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## Kary (Feb 15, 2004)

I have been dealing with this for many years. I also am one of those people who have higher blood pressure readings on the meds than off of them. What I have to do is be really careful with my diet, keep my weight under control and keep riding. The meds that seemed to work best for me were ACE inhibitors. I had to stop those since I developed a cough. The other med that seemed to have the fewest side effects with me was a Klonodine patch. I hope you find something that works for you


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## h82crash (Dec 24, 2009)

I am on atenalol (beta blocker) and I take it in the evening. If my ride is too early, the effects are still potent and keeps my heart rate from climbing and the ride sucks. If I know I will be riding before 10:00 am or so, I try to take it earlier in the afternoon the day before. I have no other side effects. I am hoping to lose a few pounds as my riding a increased and hopfully bring my BP down.


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## mtb101 (Jan 7, 2009)

there's something all you guys are missing here. why do you require meds? could it be your weight, poor nutrition, general saturated fat intake - that has led to high blood pressure, CVD? 

change your lifestyle, don't give up and get on drugs to compensate for your inability to do something about your health. guess what, your doc knows stuff all about nutrition and preventative health, their solution is to give you drugs rather than to suggest a lifestyle change, (you'd almost think medicine is a business wouldn't you????). come on guys, get focused these drugs have side effects and in the long term you'll be worse off, 50 aren't old you can change!!!!!


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## Wherewolf (Jan 17, 2004)

*Duhhh*



mtb101 said:


> there's something all you guys are missing here. why do you require meds? could it be your weight, poor nutrition, general saturated fat intake - that has led to high blood pressure, CVD?


No, pretty stupid assumptions on your part.


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## NorCalTaz (Nov 12, 2013)

I was on lisinopril until recently, I noticed the difference after I stopped taking it (BP dropped). I did find that if I was planning a ride that day, I would not take it until after the ride, this helped mitigate it.


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## Bigb2000 (May 20, 2013)

In my case part of it is unavoidable stress. My bp maxed at 174/140 ish. Last I checked it was 103/70 with meds. I'm fairly fit, but have been vegan for a few months trying to finally dish the meds.


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## elder_mtber (Jan 13, 2004)

I have been fighting high BP for years. Sometimes high like 175/100.

Lisinopril seems to lower BP a little. Also gives me the dry cough. I do not notice that it hurts my riding performance.

I tried amlodipine and it may have lowered the BP but I experienced a nasty side effect. On strenuous rides I would get super tired feeling, nauseous and, worst of all, an overpowering need to poo.

Recently the doc had me try metoprolol. It worked too "well," limiting my heart rate to about 105. Yea, 105!

Doc also tried thiazide (water pill) med. It caused extreme tiredness when riding.

I am too heavy. Weigh 200, should be 175. Have not been able to find the emotional strength to lose the weight. I suck.

Now trying verapamil and continuing the lisinopril.

Best wishes to all,
Terry


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## cdouble (Jul 24, 2007)

I am 52 also with high BP. Lisinopril didn't work for me, I am now on Valsartan HCTZ and under control. I do find my BP will drop precipitously after a strenuous ride if I don't stay really well hydrated. Also I started taking it at night install of morning so the concentration is a little lower during the day when I usually ride. If I do get woozy, I lay on my back and have some salty food.

Broke my wrist mountain biking in January, but I will be back!

Chris
Mo7s.blogspot.com

cdouble
http://mo7s.blogspot.com


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## csta (Aug 11, 2014)

Just wanted to add that this thread is awesome, thank you so much for sharing this stuff. I'm 25 with genetic hypertension (I'm in good shape, not overweight, cook 90% of my meals at home, no processed food and all that jazz), and I've been on propranolol for a little over a year now. For the last year I have made a ton of excuses for why I suck at climbing all of a sudden, and even after losing some weight, increasing my cardio cross training, riding extra hard, and practicing grueling hill climbs over and over, I've gotten no better. When my doc mentioned my heart rate was super low last time I went in, I finally realized my suckiness coincided with my starting to take the meds, and got worse when they increased the dose because it wasn't working. Since it still wasn't working, my doctor halved the dose. I am no longer sore for three days after walking up a staircase, but I still suck on climbs. This post is awesome inspiration because I know I'm not losing my mind!!!! It feels super shitty to try to explain "no really it's my meds" when you don't know for sure, and this thread pretty much seals the deal for me. I knew I hadn't let myself go that much!

Sorry for the crazy rant! Time to ditch the med and hit the trails  

(My doc put me on hydrochlorothiazide which fixed the BP issue, the propranolol helps with my headaches but I'd rather have a constant headache than hike a bike constantly!)

For anyone else who thinks they might have the same problem, one other major giveaway is when I was ride in extreme heat now (over 90 degrees), instead of overheating and sweating I get goosebumps and chills. So weird.


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## Luis M. (Jun 9, 2013)

I have to be very careful myself. Hit the gym hard (2 hrs a day) 4 times a week and bike 3x a week, usually about 2-3 hr rides.Watch salt intake and I'm good. If I deviate in my exercise routine it immediately creeps up! I'm also big on all natural supplements. I take GHR1000 religiously. They also have BP specific supplements you can consider!


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## elder_mtber (Jan 13, 2004)

hydrochlorothiazide - this drug lowered my blood pressure by reducing my volume of blood. Made me weak. I had to stop taking it after a week or two.

propranolol - this drug dramatically reduced my heart rate. Left me unable to climb, ride tough tech sections, etc.

Lisinopril helps with my blood pressure. 20mg day. Riding hard also helps.

I have tried a number of drugs. Many are worse than the disease, for me anyway. If I can't be active, then I don't care much about...

Good luck with the hypertension. I have no good answers, kinda like the MDs.

It really is time to (maybe) ditch the meds and hit the trails.

Best wishes,
TR


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## Ridnparadise (Dec 14, 2007)

mtb101 said:


> there's something all you guys are missing here. why do you require meds? could it be your weight, poor nutrition, general saturated fat intake - that has led to high blood pressure, CVD?
> 
> change your lifestyle, don't give up and get on drugs to compensate for your inability to do something about your health. guess what, your doc knows stuff all about nutrition and preventative health, their solution is to give you drugs rather than to suggest a lifestyle change, (you'd almost think medicine is a business wouldn't you????). come on guys, get focused these drugs have side effects and in the long term you'll be worse off, 50 aren't old you can change!!!!!


Hypertension is the greatest cause of CV disease. It is 8x more likely to cause heart disease than cholesterol or smoking and in all but a tiny percentage of cases is idiopathic - ie no known cause other than aging. Treating hypertension is not giving up. Weight loss can help, but does not always. Exercise makes almost no difference at all. Not treating hypertension is plain stupid. Please don't make uninformed comments about something you clearly know nothing about.


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## kb2wji (Apr 25, 2011)

I've been "pre-hypertension" since I was in my mid teens. I'm active and in good shape. My diet isnt great but its not terrible. No clue whats going on. I started Lisinopril 5 years ago. 20mg / day. I dont have any side effects and dont notice any difference in my physical ability. Knock on wood.


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## elder_mtber (Jan 13, 2004)

error csta, I meant to reply to you.

TR


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## Bigb2000 (May 20, 2013)

The Lisinopril gives me a serious cough when the heart rate goes up. I also get the chills when riding in the heat. The hot weather really takes a toll on me now, which is weird because I've lived in the deep south my entire life. My suggestion would be not to stop taking the medication, but communicate with your MD about the physical demands riding takes. If they don't ride, they probably won't understand otherwise.


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## Guest (Aug 12, 2014)

Wherewolf said:


> No, pretty stupid assumptions on your part.


 What you said. Apparently no issue with age or genetic in that family. I'm at a healthy weight, eat well (good nutrition, not a lot), watch my intake of everything and exercise more than most folks my age and I'm borderline. Not on meds for that yet, but taking acid blockers for chronic heartburn. Guess I should change my lifestyle (quit eating and exercising) so I can get off those.


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## Ridnparadise (Dec 14, 2007)

Bigb2000 said:


> The Lisinopril gives me a serious cough when the heart rate goes up. I also get the chills when riding in the heat. The hot weather really takes a toll on me now, which is weird because I've lived in the deep south my entire life. My suggestion would be not to stop taking the medication, but communicate with your MD about the physical demands riding takes. If they don't ride, they probably won't understand otherwise.


There are some consistent comments in this thread about the effects of lisinopril (an ACE Inhibitor) on exertion and well being. ACE Inhibitors have changed the management of blood pressure control. They work on a system involving the hormones renin and aldosterone, the kidneys and adrenal glands and have been shown to reduce coronary and cerebrovascular events in males and females with normal blood pressure. They are very successful at reducing blood pressure in hypertensive people and while there are adverse effects like cough in 15% of people, the restriction of physical performance is not something reported in the wider medical media.

Hypertension is mostly asymptomatic. However it can cause chest discomfort, abnormal heart rate response, shortness of breath, easy fatigue and headache.

What is not clear in these posts is whether there has been poor blood pressure control during exertion on ACE Inhibitors (or all the time) or something else going on; like pure chance symptoms. Exercise has been shown to raise the pressure of peripheral blood vessels, while central vessel pressures remain stable. Therefore the concept that being on ACE Inhibitors to control hypertension reverses the subjective benefits of having good blood pressure when exerting is unexpected.
I guess I need to hear more more


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## csta (Aug 11, 2014)

elder_mtber said:


> hydrochlorothiazide - this drug lowered my blood pressure by reducing my volume of blood. Made me weak. I had to stop taking it after a week or two.
> 
> propranolol - this drug dramatically reduced my heart rate. Left me unable to climb, ride tough tech sections, etc.
> 
> ...


I don't think the hydrochlorothiazide has given me any problems yet, or at least not any that are noticeably worse than the propranolol. Unfortunately staying off them is not really an option for me, I've got a history of genetically high, treatment-resistant hypertension on both sides of my family, and every woman has died of heart related issues.

But there are a lot of meds that will treat hypertension, and since I'm only 25 and I'm not likely to get any skinnier or fitter, I might as well do the work to figure out what works best for me.



Ridnparadise said:


> What is not clear in these posts is whether there has been poor blood pressure control during exertion on ACE Inhibitors (or all the time) or something else going on; like pure chance symptoms. Exercise has been shown to raise the pressure of peripheral blood vessels, while central vessel pressures remain stable. Therefore the concept that being on ACE Inhibitors to control hypertension reverses the subjective benefits of having good blood pressure when exerting is unexpected.
> I guess I need to hear more more


Propranolol is a beta blocker, not an ACE inhibitor (I think), so I can't speak for them, but the chills in hot weather riding was the first thing I noticed. I didn't really notice the weakness on climbs until I moved from Virginia to California. I thought I was just not used to climbing anymore. I did 2 months of practicing hill climbs on my bike and doing 2-6 miles of running/hiking straight up and down massive hills with minimal issues. I then went on a group ride on a trail I used to do when I lived in CA before, and I was at the very front easily the whole ride until we hit a sustained steep climb. Within less than a minute I had dropped behind way the sweep, and the ride leader actually had to come back and asked if there was anything medically wrong with me. This is pretty much routine on every ride I do now; I'm pretty much fine on short or mild climbs, but the instant it's a steep and sustained climb I hit a wall barely 50ft in.

The doc said she was concerned my heart rate was too low the last time I went in, my bp was 154/95 but my heart rate was only 51. Reducing my dose from 80mg to 40mg (and adding the hydrochlorothiazide) was definitely a noticeable improvement, but mostly just in that I recover much, much faster. The climbs still suck. I'm trying 20mg now but it takes a couple weeks to adjust every time.

I'd love to get to a point where the steep climbs are just hard instead of impossible. I don't get this from hiking or running. With those I'm not as strong as I used to be but they're still possible.


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