Medicines that raise Heart Rate

Hello all. Phrasing this very carefully and also avoiding specifics as I don’t want to get medical advice. It’s more scientific knowledge I’m after…

Basically I’m likely to be prescribed one of various medicines for a condition, and one option, though apparently effective, has the side effect of raising heart rate. Not dramatically, about 5bpm seems normal.

My question is, in terms of my training, does that matter?

By which I mean, would the raised heart rate be an indication that my cardiovascular function has been impaired temporarily in some way and I am likely to find my FTP dropping - or is it just a random effect, and I would be able to put out the same watts and feel the same, but my heart just happening to beat a little faster?

There is no way to tell with any certainty without knowing a lot more details. A lot more goes into your cardiac output than heart rate.

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Agreed, this post is almost too vague. I’m sure there’s 100 ways to increase someone’s HR and only some of them would result in decreased fitness. And maybe some that could increase your performance (like caffeine).

HR is pretty individual and a drug that raises your HR may just change your personal baseline.

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Thanks guys. Yes apologies for being vague. I’ll be more specific, it’s an asthma inhaler with what’s known as a long-lasting beta agonist. So it would be making me breathe more easily, but studies show that it raises resting heart rate in patients over the 12 hours that it tends to work.

(The ultimate question is about whether I just go for this medicine or ask about one of the alternatives, which I will discuss with my doctor obviously - but I don’t think my doctor has much experience with athletes.)

Good point about the caffeine!

these have long been known to be performance enhancing and are on the doping list…
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I am certainly no medical expert to take advice off @martinheadon but my guess would be it depends on whether its an erratic 5bpm or a stable 5bpm . If its the former it could be dangerous at high intensity but if its the latter the heart/body would become conditioned to operate at the higher bpms.

Lol, Slightly OT I shocked my ex coach back in 2018/19 when my HR went up significantly, it had been artificially supressed by an underlying health problem, which once removed saw my bpm shoot up (I forget the numbers) but it was actually much more stable than it was before :joy:

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Interesting question Martin and something I have wondered about recently.

I realised this winter that I was suffering exercise induced asthma when training near max (vo2) efforts in my cold garage - vo2 work would cause asthma attacks and breathing difficulties. So I was prescribed an asthma inhaler and I use that only before vo2 work. It increases my HR noticeably on those sessions and I can now hit and maintain HR rates in the 95% max range that would have caused me to have an attack and force me to stop working early. I can maintain a respiration and HR rate I couldnt without using the medication.

My take on it is that it is enabling my training at that level and hence will be improving my fitness/performance, simply because I couldnt do that work effectively before, and I understand high HR to be desired to stimulate central adaptions during vo2 work. I dont use it for anything other than vo2 efforts, but if I was using it for SST work it would mean a higher HR than usually required for that power output, so strikes me as counter productive and not a great thing for my fitness?

I may have it all completely round the wrong way though :man_shrugging:

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I have taken a medication (elavil) for a chronic back condition and nerve pain. The smallest tablet is 25mg. When I take that, my resting HR went up probably 10-15 BPM. For years I took 1/4 tablet and had minimal impact to HR. I currently take 1/2 tablet and probably have a 5 BPM increase. It has not impacted my training at all as far as I can tell. I’m 63 and resting HR is currently 58-60.

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Indeed, though I believe there are limited allowed amounts even without a TUE. But I’m nowhere near competition level right now anyway so will cross that bridge when I come to it.

From what I can tell it has a fairly steady rise peaking around 6 hours after taking and returning to normal after 12 hours. As it would be taken twice a day, I would be spending most of the day with my resting HR higher than normal but not aware of any likely “spikes”.

Yes, this expresses the dilemma very well. At the moment just “enabling me to ride my bike more” is the main goal and I’m not really intending to be pushing to max much anyway. But if I do start training harder, it’s trying to figure out, is a higher HR at what I think of as threshold power mean that actually I’m above threshold, or is it the same physiological cost just with a higher number than normal?

When you say it hasn’t impacted your training, has it impacted your heart rate during training? As in, is it always 5bpm above where you’d expect, or does it just have a higher resting rate and then go back to “normal” when you start exercising?

As a long time asthmatic, I say take the drug that gives you the most comfort, and don’t worry about the heart rate increase if that’s the case. There is nothing worse than your lungs feeling awful when you try to do hard efforts.

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I ventured down to the (very cold) garage again this morning as it was trying to snow outside!

Plan was over/unders at 110/90%, so I played it safe and took a puff from the inhaler. I did a harder session than I had before, better numbers and longer duration, and saw a very slightly higher HR than last time without the inhaler. Definitely helped me through a productive session so I’d definitely class it as beneficial today.

I think I’d agree with the comment above about taking what you need to train, especially if you’re not competing. I wouldnt worry about a few bpm during your training.

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As another EIA sufferer, I can only emphasize that you should take what you need, when you need it. I used to only take a “hit” when riding in the cold (when my EIA would really flare up), but now use it before any ride / session at or above SS.

About 2 years ago my primary doc made the observation that I was only depriving self of oxygen by not using the inhaler….and she was right.

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Thats a good prompt and I think I may try that during my threshold work in the coming weeks.

I recognise I have a belief about only taking medicines when absolutely necessary, and maybe thats limiting me in this situation? Perhaps time to test it.

That was very much my mindset….her comment was a game-changer for me.

A real world example - our Tues / Thurs AM group rides are very fast-paced, with occasional attacks, but mostly a fast rolling pace line (25+mph). Just after I meet everyone, there is a small hill where an attack inevitably happens, but a stoplight about 1km later always stops us. (But still we attack in the hopes that “this time” we’ll catch the light and get away :man_shrugging:)

Anyway, prior to her comment, I would get to the light, gasping for air once we stopped….but chalked it up to having just gone hard, etc (which was obviously part of it). After her comment, I now arrive at the light still breathing hard, but no longer feeling like I am trying to find oxygen that doesn’t exist.

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That is hard to say. I have been taking this for many years and haven’t had any heart related issues. My resting HR did go up slightly when I went from 1/4 to 1/2 tablet, but I can’t quantify by how much. My point was I haven’t noticed any training problems related to higher HR.

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