Participation in Exercise While on Beta-Blocker Medication

QUESTION: Because of a case of high blood pressure that was difficult to
treat, I am now under control with medication (beta-blocker). I think I would
feel even better if I could participate in an exercise program we have here,
but as you know, my pulse is also lower due to medication. Can I participate
in the program and will it do me any good to try?
------------------------------------------------------------------------------
ANSWER: Many people must find themselves faced with your problem, for since
their introduction in 1966, the beta-adrenergic blocking drugs have become
widely used to treat a variety of heart conditions as well as hypertension.
As you correctly note, these medications affect your heart and therefore your
pulse rate, and may lower this rate from 15 to as many as 60 beats per minute
when you are exercising at moderate levels, the amount depending upon your
body's reaction and the dose of medication you are taking. But the effect on
circulation may be less dramatic, for as the heart beat is slowed, the amount
of blood pumped out with each contraction increases, keeping the flow of blood
to the body near normal. The beta-blockers may also lower your breathing or
maximal ventilation capacity, which may in turn diminish your ability to
continue your exercise activity over prolonged periods. However, the results
of a number of investigations that deal with your question would seem to
indicate that you may well derive considerable benefit from a training
program. There are a few precautions for you to take. The amount and type of
exercise should be based upon the results of a treadmill test, which should be
conducted as much as possible in a manner that simulates the conditions you
will be under when exercising. You should be on the type and amount of
medication that you will be taking during the time of your new activity.
Since it is apparent that you had trouble in controlling your blood pressure,
changing medications may not be advisable in your case, but the beta-blockers
that act primarily on the heart allow greater flexibility in planning, and
therefore a greater return from a well considered exercise program.