What blood pressure medications should runners take?

My girlfriend Sweetie is saner than I am and so I agreed with her that I should get a full physical exam, with special attention paid to factors that might make me keel over dead in the middle of a long run. So, having done that, what’s up?

  • My cholesterol is hanging in there, though my LDL is quite a bit higher than it should be. It’s not going up, at least, and my HDL (“good cholesterol”) number is still off the charts.
  • My blood pressure continues to be an issue. Though it seems OK, usually, when I measure it in one of those drug store machines, in the doctor’s office it likes to come up as 140/90: right at the low end of hypertensive. If I’m hypertensive sitting in an office, it’s a little scary to think of what might be going on during a five-hour run. Sigh.
  • The doctor gave me an EKG and didn’t entirely like some of the readings. So now I’m going to get a more conclusive test, an echo cardiogram. From what I can gather, this is basically an ultrasound of the heart. I plan on making at least one lame joke to the technician about not wanting to know if it’s a boy or a girl.

I’m getting the echo cardiogram February 6th and then talking with my doctor about that and about blood pressure medications a little after that. I did a little research on blood pressure medications for endurance athletes (am I an endurance athlete?) and found out some interesting things. Mostly, of course, people who put in a lot of hours of training, simply don’t have high blood pressure. But there are exceptions. What medications can they take?

  • Diuretics? No. Diuretics, i.e. “water pills”, are the major class of hypertension medications. They work by making you pee more… less hydrated blood means less pressure. You can see where this could be a problem, right?
  • Beta blockers? Heck No. Out of the question, if you want to keep exercising intensely: among other effects, they keep your heart rate down. Try to run and you’ll be exhausted in no time.
  • ACE inhibitors are apparently the way to go. These act to counteract the bodily signals that cause constriction of the arteries and veins.

I learned this stuff from the article “Managing High Blood Pressure in Active People“, by Dan Ullrich, on HealthLink. I’ll be interested to see how aware of these issues my doctor is.


18 Responses to What blood pressure medications should runners take?

  1. Jack Bog says:

    You may want to try taking your own blood pressure readings at home. Some people have their pressure rise substantially just because they are in the doctor’s office. Taking readings at different times during a normal day can be enlightening. The Omron brand cuff that goes around your arm (not wrist) works well. Costco has it for $70. Data is power.

  2. Kelly says:

    You are not the first friend I’ve had who runs marathons, yet struggles with blood pressure and cholesterol. It always pained me to see my other friend (Rodney) bring his healthy little meals of kamut and greens to our workplace, attempting to bring his physiology to heel. People who exercise punctiliously should be able to eat whatever they want.

    But, he’s an atheist too. Maybe God is punishing you both. I’ve never denied God, so I get to have a blood pressure of 110/70 despite my general inactivity and wretched eating habits. And, my upper feet never pain me.

    • dawn says:

      I am Christian, but I realize insulting and hurting those who do not know the Lord is not His will. In the bible, He says, ” . . . for he maketh his sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust (Matthew 5:45).”

      This means that according natural law, some of us have different make-ups than others. We should be wise stewards of the temple of God (our bodies); but even with all our tedious efforts, there are areas of our flesh that may not conform.

      I suggest getting to know Christ for yourself, but not to avoid punishment–to invite the reward of a fulfilling and nurturing relationship with Him. :)

  3. Tom says:

    I too have run several marahtons, and have high blood pressure. My 4mg ace inhibitor is working fine. One caveat, in hot weather, I get dizzy, as the blood vessels cannot constrict due to loss of blood volume (water), and keep the pressure up. Good luck with the echo…I was sent to one and ended up getting OHS and a new aortic valve last year! Right back running tho!

  4. Greta says:

    I am troubled by irregular heart beats. My cardiologist doesn’t think I need beta blockers, but my other doctor thinks I should take them. I run almost every day, hills three times a week and am worried I’ll be tired too soon with beta blockers.

    I also have high blood pressure (surprising in a runner, my doc said) and take medication.

    Neither one of my doctors are runners so they can’t really relate to my concern! sigh—

  5. Tina says:

    BP is low most of the time, and then it goes up for days. Feel emotional, hot in the face – even on the eyelids, stressed in the back and wonder..I have a road race coming up – do I run it – all 10 miles – with my BP at 148/95? Yikes!

  6. gerry says:

    I ran while taking a beta blocker for 7 years before it caused me any problems. I took it for an irregular heartbeat, and it was very effective. When I first started using it, I finished a 9 mile run at 8:30 pace and my heart rate was 76. I ran many road races during that period. Now, 20 years later, I take several bp meds including the beta blocker, but still exercise – walk/jog, swim, bike – and they all do a good job of boosting the affect of the meds and lowering my bp.

    Kelly’s religious comments are absolutely moronic. Bp is hardly the only health hazard out there, and a self-serving, holier than thou attitude is sure bite you in the end.

  7. Scott says:

    Interesting about the beta blockers. You didn’t notice any increased fatigue while running?

    Kelly was joking. You’d have to know her to tell, though.

  8. elaine says:

    Have a rare genetic condition so now on 4 times average dose of beta blocker to lower blood pressure. Struggled to run 2 marathons since but my times are an hour to an hour and a half slower- 2 to 3 minutes a mile. I hate it but my cousin died of a ruptured aorta so I don’t think I can do without.. My heart rate does not get over 100 ever. Running is tough on a beta blocker.

  9. gerry says:

    @Scott: no the beta blocker didn’t bother me for 7 years. Maybe because I was only taking a low dose. After that, however, I couldn’t sustain running with my heart rate so low. I can still swim, bike, walk/jog.
    @elaine: stay on the meds because they are important for your health long term. Can you be happy doing shorter races. Marathons have a certain glamor but they are not necessary for essentail cardiovascular fitness. 5-10k’s are good enough.

  10. eric says:

    Yeah training for 18.6 miles myself dropped 34lbs in about 3 months and expected the numbers to go down. But it came out 148/70. Now I was stressed before leaving for the doctor right when I was out the door the network I was maintaining decided to crash and I got stuck working on it an extra 2 hours. Caused me to miss a meeting and lunch (had a few peanuts in the car).

  11. dawn says:

    Thanks, guys for all the information. I ‘searched’ the Web for info. on high blood pressure meds and running, and found this site.
    Now, I’m armed with information for my doctor. I absolutely have to change medications–While I can force myself to run every morning on the meds, I feel like a tremendous weight is in my chest and it’s going to explode.
    Also, I’ve lost lots of muscle mass and my flat stomach looks 5 mos. pregnant.
    I worked really hard to tone up looking good was a by-product. Now, I’m sad that all my hard work is going down the tubes. :(

    • gerry says:

      For those runners who end up needing a beta blocker, I recently replaced my longtime dose of atenolol with carvedilol and have been doing considerably more running than walking because my resting pulse is now 52 instead of 42. Bp meds react differently with different people but this one might work for you.

  12. Charles says:

    Was a runner for years with normal blood pressure but had been diagnosed with bradicartia (low pulse around 30 at night, thanks to rocky mountain spotted fever while in the Army) had a pace maker plug and play installed for said problem last summer. Then after surgery ended up having hight blood pressure (go figure)Was put on carvedilol for high blood pressure it was ok first month then it was like I got Asthma could not run with out feeling there was an elephant sitting on my chest. Got the doctor to switch me to another med a calcium blocker, work good first two weeks running again with out problem. Then the swelling in legs and ankles started and had pain running. Waiting for a call for new type med as I type thinking of asking for ace inhibitor.

  13. Brian Tylicsz says:

    I have been running for 10 years on a Beta Blocker and I hardly ever notice a decrease in stamina. I was on Inderal for a couple of years but it did have a side effect of lowering my resting heart rate too low for my comfort. I am currently taking 5mg of Bystolic (relatively new) and I love it. No side effects at all. Stays around 120/70. I’m 44 y/o.

  14. claypatten says:

    I am 52 years old started back running and biking at age 46, have run 50 mile ultra last 3 years and this past May ran a 100 mile Ultra but had to do it in a loop as I have asthma and needed 3 breathing treatments after my Advair stopped working for me at mile 48. The Advair I believe contributes to my high blood pressure. I take Lisinopril and Amlodepine both calcium blockers. I believe the arrhythmia I get is from a potassium retention issue from the calcium blockers (a side effect of the meds) Still waiting to get a blood test at the right time when I am having a bout of arrhythmia to confirm my self diagnosis. Arrhythmia seems to get better when I get off meds for few days then start back up with less dosage. Looking for info on this matter. THanks!

  15. Dean says:

    claypattern: Lisinopril is an ACE Inhibitor, not a Calcium Channel Blocker. Running witha beta blocker was like running in a vat of molasses to me. The ACE Inhibitor is much better for runners.

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