'Maximum' Heart Rate

[BDF2]

During one of my cardiac rehab phone calls I let slip to the nurse some of the heart rates I was seeing while cycling (only into the 150s). She made a slight squeaking, noise, tapped some numbers into a calculator, and told me I shouldn't be exceeding 140 bpm.

At the time I didn't question it as the heart attack was only a couple of months earlier and I was still building my fitness back up. But since then it's started to feel quite restrictive. I'm finding it too easy to hit 140 bpm without feeling that I'm working particularly hard. It's a particular issue cycling uphill. I've encountered hills where I've felt I had to stop halfway up, not because I was finding the cycling too hard, but because my heart rate had crept far enough past 140 that I was getting nervous about what might happen. Before the heart attack I would have seen my heart rate going up into the 160s on those sort of hills without any worries.

Does anyone know what risks, if any, I'm running if my heart rate does stray above 140? When I'm cycling with other people it would be nice if I didn't have to hold back quite so much on hills and keep them waiting for me to catch up. My limited understanding is that the restriction is down to the fact I'm on 1.25mg Bisoprolol.

[SheldonC]

I would speak to your cardiologist, the Cardio Rehab nurses and nursing staff in general tend to err on the side of caution and quote the "one size fits all" response, e.g. 220-age*85% (85% might be wrong i don't remember exactly), they do not take into account any prior fitness etc. etc.

My cardiologist told me to to ignore them and to simply go by how I feel, i exercise regularly and get mine up in to high 150's, he is perfectly happy with this.

I am on 2.5mg Bisoprolol twice a day, they will act as a de-limiter so you may find you run out of steam sooner than you used to when pushing harder.

Obviously you MUST discuss this with your Cardiologist, I would not bother with the nurses as I said.

Good Luck

[BDF2 in reply to SheldonC]

I don't think I have a cardiologist. I had two angiograms (they fitted the stent during the second) done by different surgeons and the ward I was on was overseen by a different consultant. I did have a follow-up phone call 6 months afterwards with one of the two surgeons but that was over 18 months ago and that was the end of my contact with the hospital.

[SheldonC in reply to BDF2]

Then I would speak to your GP and see what they say! But unless you’re lucky they probably will say same as the nurse. I guess you could ask for a referral to a cardiologist or go private or take a chance!

[Gordon_N]

BDF2, consider an e-bike for keeping up with your mates. Some really cool road bike versions available. I haven't secumbed yet, but only because new bathroom is priority for my wife. All the best.

[santino44]

Understand where you re coming from can get up to 150bpm just fast walking although looking at 90-110bpm but finding it difficult as I would need to slow down.Just checking Have you come across the Maffertone Method the science makes sense.

[BDF2 in reply to santino44]

Thanks for the suggestion. I've just had a look at the Maffetone Method and by pure chance that seems to be what I'm doing for the most part. On my longer rides I'm averaging 115-120 bpm and the formula suggests a max of 122.

[Fazerboy]

Not sure if this helps but here goes. I am a 65 year old cyclist and use a garmin hr monitor. I had svt and then an ablation. No svt now. I was on 1.25 mg of bisoprolol before my ablation and it made me very tired and it wouldn’t let my hr go over 100. I stopped the biso for my ablation and have stayed off it since. Admittedly svt is different to a ha. I initially limited my hr to 100 then gradually increased it. I now let it go up to 150 for short periods. I personally wouldn’t worry about being a bit slower than others, they haven’t had a ha. I just use lower gears if needed and ride to a max hr figure that I am ok with. You tend to know yourself if you are pushing it too far.

[Heartbear]

Hi BDF2,

As TWU says,our risks were probably before our HAs. In my case at 51 in 2020 with a 'big' HA (LAD was 100% blocked, so I'm very lucky), rehab team has advised to keep my HR at 150 or below during moderate exercise. I am now back to running three times a week 5k each one, and monitor my HR to be around 150. Occasionally it strays towards 158 for a few minutes, but no big deal - as a civil engineer I get the tolerance. Turning 53 this weekend and feel better than ever. All the best, Graham

[BDF2 in reply to Heartbear]

Hi Thatwas unexpected & Heartbear,

Heartbear - I'm jealous that the rehab team gave you a ceiling of 150 bpm! I was 46 when I had my (as far as I can tell very mild) HA back in 2020 and it was only a partial blockage, with an echocardiogram not picking up any discernable damage. Being given a maximum HR over the phone from someone who's never met me just feels very arbitrary.

I have been careful to build things up gradually and it was over 6 months before my cycling involved much more than the commute to work. It's reassuring to hear from others who've been through similar experiences and are getting their heart rates up without issues. TWU - your HR trace is particularly cheering, I was just hoping for reassurance that nothing too horrible would happen if I let my HR drift into that sort of territory for a couple of minutes here and there, not hold if there for 30 minutes😮 Very impressive.

[Pegleggreg]

Have you read all the other related posts on max HR? Interesting that during cardiac rehab following my HA they never concentrated on HR rather than perceived rate of exertion. Can you still hold a conversation during your exertion? Dizziness light headed feeling chest pain, then stop. Recovery HR was focused on post exercise. It’s always been a grey area for me because unless the nurse/doctor has been a serious exerciser then I’m not sure they possess the necessary insight and will stay on the side of caution. Good Luck and keep on exercising with others if possible. Do you have Strava for safety alerts?

[BDF2 in reply to Pegleggreg]

I did have a search of the related posts but none of the ones I found explained what risk, and what form it took, exceeding the suggested maximum had.

I'm afraid that my cardiac rehab didn't concentrate on much of anything at all. It consisted of 3 or 4 phone calls that started about a month after my heart attack, most of them taken standing at the side of busy roads as she often called while I was having my lunchtime walk (part of my DIY rehab program cobbled together with ideas off the internet as I had given up waiting for them by this point). You never knew when the next one was coming so it was difficult to be prepared with sensible questions, there was a gap of two or three weeks between some of the calls. I think we talked about RPE very briefly, it was me who brought up the subject of heart rate.

From a RPE perspective I'm not worried that I'm pushing things too hard. Conversation isn't a problem and I've never had an issue with dizziness when exercising. Even going up the steepest hills I'm only talking about 15/6 (depending on which flavour of Borg scale you prefer).

[Prada47]

Sorry I have to ask myself Why ??

Unless your training for the Olympics why would you need to push yourself to the upper limit of what possibly could be dangerous.

Why do Fit people sometimes drop dead ? is it because Fit is not always related to Healthy, as it looks like was the case with yourself.

I would suggest you use a Exercise Bike in your local gym to push your Heart Rate as they will have an AED should you require one, and you wouldn't fall off your Bike in front of a passing Car or worse still a lorry.

This sounds very very negative but as I started out Why ??

[JulianM in reply to Prada47]

Connection with the landscape, the weather, nature, the people one rides with, the feeling of being fully alive. I think there are many other reasons for getting outside on a bike, but these are just a few that occur to me from my personal experience! I work in a gym, but riding an exercise bike there isn't quite the same.

As a very wise and helpful GP said to me, there are questions here about 'appetite for risk' which are extremely personal and outside the remit of medicine. I think this is an area where we all need to agree to differ in the friendliest possible way, providing we're not putting others at risk or disrupting their lives unreasonably and without their consent.

[ChoochSiesta in reply to Prada47]

Why? To be the best that you can be. I know what I was capable of, on my bike 3 years ago, and my ambition is to get back to that level. There is no rush, but I certainly want to try.

[BDF2 in reply to Prada47]

I may not have explained myself very well. I'm not talking about pushing myself to any upper limit. In terms of rating of perceived exertion I'm not talking about going above 15 (6 if you want to talk modified Borg instead). It's just that on longer climbs, despite my RPE not changing, my heart rate starts creeping above the very low seeming maximum I was suggested. Even the higher heart rates I have seen aren't approaching my aerobic threshold, let alone taking me into anaerobic territory.

[BDF2]

No, one of the surgeons did say that there would be damage and other, more sensitive tests would be able to see it. But the damage want severe enough to affect my heart sufficiently to show up on an echocardiogram - which I take as a fair result.

[Milkfairy Heart Star]

You can have micro infarcts in the small vessels of the heart.Micro occlusions or microvascular dysfunction.

These can sometimes be picked up on newer Cardiac MRI machines.

[ChoochSiesta]

My GP is also a keen runner. I have also never had high blood pressure and can't understand why I am on BBs and Ramipril. I may need a similar conversation with the GP!