Heart rate too low?

Heart rate too low?

I’m struggling to get my heart rate into the target zones when I’m training. I take Propranolol 40mg twice a day prophylactic to reduce migraine. I understand it slows heart rate; my max HR has reduced and resting HR is 15-20 less than prior to taking medication. Will I ever be able to get into my zones again? I was able to reach them a few years ago when I wasn’t on beta blockers.

Helen Shaw

Beta-blockers (e.g. Propranolol, Bisoprolol) are a group of drugs that are used to treat several heart problems, including angina, irregular heart rhythms and heart failure. They also treat high blood pressure and a range of other conditions, including prevention of migraine. One of the effects of a beta-blocker is to slow the heart rate. The extent to which it does this varies depending on the drug and dosage used and also on the individual taking it.

Although your heart rate will still increase with exercise when you are taking a beta-blocker, you should not expect to be able to achieve the same maximum heart rate during exercise that you did before. Despite this, you will still be getting a good cardiovascular workout – albeit at a lower heart rate. It is therefore probably better not to worry about a target heart rate but keep it simple: exercise hard but without overdoing it. Aim to feel physically tired without pushing yourself to the point of exhaustion.

Since many side-effects of beta-blockers are dose-specific, if your migraines are well-controlled on your current dose of Propranolol, you could talk to your GP about reducing the dose gradually until you are on the minimum which controls your headaches effectively.

Matt Brooks

Cycling GP

This Q&A was published in 'Cycle' the magazine for members of Cycling UK. To contact the experts, email your technical, health, legal or policy questions to editor@cyclinguk.org or write to Cycle Q&A, PO Box 313, Scarborough, YO12 6WZ

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