a long question on the Impact of BP drugs on athletic performance

I was pretty committed in my youth (a couple of county titles and inter county xc vests) right up until my early 40’s when I scraped a decent finish in the British 10km Vets champs in my age group but some long term injuries, plus work and family commitments have really stopped me from training properly since, and consequently competing. I have continued to run several times a week in the interim but more (I turned 60 in October) recently have made a serious effort to get from jogging fit, to competitive in my age group fit. I ran 21:06 last week at the local Parkrun off about 4 weeks of structured training (circa 35 mpw) and if I am honest expect to dip under 20 mins by xmas or January and if things go well, and I avoid injury, who knows….

My question is not about training but the impact that some drugs that I take for a couple of conditions, will have on my performance. I have suffered with Astha from the age of 4 and if I am honest for many years as a child and young teenager it was pretty awful at times and difficult to control. I take medication daily and dont know if that held me back but cant be changed, fortunately it is well controlled now.

I now have slightly elevated BP and after a dose of Covid then Pleurisy I have also have AF and take several meds including Apixaban, Cardiplen and Ibersartan. In short I wondered if anyone had any experience of trying to perform at a “competitive” level when on these drugs?

Of course of I have asked my GP etc about this but their focus is on my general health (of course) as oppose to me improving my performance, they are happy I can run “hard” without causing any problems.

If you have read this far I appreciate it.

I used to compete at a decent level doing trailquests (even won a national round once!) – but I went on drugs for high blood pressure 15+ years ago (I’m 56 now).

In a few months I literally went from riding at the front on club rides to hanging off the back and the pills essentially ended cycling for me as riding was always about the competitive side. I was never one for just going for a ride. Even weekend rides with mates always ended up being a race to see who could drop who.

Doctor never put any restrictions on what I could do though. We may have been able to find a combo that worked but we’d tried many and I’d got out of the riding habit.

Any beta blockers or anti-arhythmics? Bisoprolol and Flecainide messed me up for pretty much any activity for 2.5 years. Thankfully off them now.

When I first got put on BP medication (largely due to family history), I was given one from the ACE inhibitor family which made me cough, and also I felt like crap. No energy. Tried another one in the same family, and that was largely the same. So the next one I got given was Losartan. I really tried with that, but my athletic endurance fell through the floor.

I went out one day for a 15mile XC ride, on largely flat ground and really struggled. I’m not an athlete but had never had that kind of issue before. So I came off that one, and now I’m on Amlodipine, and I have NONE of those issues.

Equally however, I know others on ACE inhibitors that have no issues.

So the short answer is ‘find one that works for you’.

No. No beta blockers. I have an appointment with the nurse tomorrow and my Systolic is in the “high” zone, just. I will suggest an increase of my current meds as oppose to any new ones and definitely not beta blockers if I can avoid them.

BP and heart drugs have absolutely ruined any form of vigorous cycling for me. I max hr is maxing out at 130bpm which means effective climbing is interesting.

I can still cycle up to about 60 miles and I haven’t resorted to an ebike. It’s frustrating but I am 70 and better off than some, but doesn’t fill me with joy.

@the-muffin-man Sorry to hear that. I am have a bit of competitive nature, age group athletics at lease help me think I am “racing” even though I know I am just going through the motions. Not sure if I would remain motivated if I couldnt race.

It’s frustrating but I am 70 and better off than some, but doesn’t fill me with joy.

You are right, I feel the same but I have friends who would love to be out running who were very fast many years ago but for one reason or another cant run at all, not to mention those who are not around anymore. I count myself very lucky.

The key things for you will be your max heart rate post illness (with drugs) vs before, and likewise peak flow, which may have taken a slight hit without you realising, even though your asthma is well-controlled. Both are obviously the limiters on max efforts, and while your GP will be recommending exercise, does he/she realise what you mean by ‘going hard’?

I’ve been on ramipril for 15 years….I didn’t notice any impact on my athletic performance.

I may be wrong, but I believe that they won’t prescribe ramapril at your age (Ace inhibitor) they’ll put you on a calcium channel blocker instead.  I’m on both now!  I’d be amazed if they gave you beta blockers.

@martinhutch when my AF was being investigated I wore a unit around my chest for 7 days. I made sure to do a couple of sessions where I ran hard and I had the conversation with the consultant and explained that although I was slowing, obviously due to my age, I did push myself as hard as I could occasionally and during races. He explained that this was fine but if I experienced anything untoward I would stop (which I absolutely would of course)

My HR “window” has always been quite low. I have a resting HR of around 32 but a low max of around 142. The highest I have ever recorded is only around 165.

I had an MI 9 years ago at 41 and end up on an ACE inhibitor and beta-blockers.  I’d been running at an OK level but was told I wouldn’t ever be as good. It was a bit of a red flag for me and I decided I’d like to try and prove them wrong.  I think because I was at such a low level after the incident that I had to basically start from scratch with the meds and just slowly built myself back up over a number of months without getting into difficulties.  After I’d had a repeat ultra sound on the heart and was told it was back to normal I went a bit harder with the training but I think I had adapted over that period with the drugs so I was used to them being in my system.  Since then I’ve had 4 champs places for London and recorded my fastest marathon this year at 49.  Maybe I got lucky and got the right meds that work with my rather than against me, or I adapted well to the drugs.  I don’t know but I’ve certainly improved my running in the last 9 years.

I have paroxsysmal AF and take Flecainide for it when it happens (i.e. not all the time). I hate the stuff, makes me feel like shit, but I’m never in the right frame of mind to exercise straight after an AF episode anyway, so can’t give feedback on it for that.

Back when I was on it full time though… I’m not sure. I certainly felt like I was less able to run, but I was not at my fitest back then anyway so cannot really compare with anything.

One thing is for sure. If I take flecainide, I am not exercising for a day anyway. AF is my body telling me I have gone too far, too fast, or that I am ill.