Beta Blockers

[Coopergirl52]

If you are on Beta Blockers to slow your heart down what is the normal beats per minute as a normal bpm is between 60 to 100 bpm.

[Chappychap]

Great question.

This was discussed in detail on the Cardio Rehab course I attended, unfortunately there's no precise answer as each individual will react differently to beta blockers. Informally the nurses hinted that it was fairly common for beta blockers to knock off about 10 beats per minute for resting heart rate, but that beta blockers could easily reduce an individual's maximum heart rate by far more than this.

The main focus of the Cardio Rehab course was the impact of beta blockers on exercise. The oft quoted formula was taken as the starting point (220 minus your age = max exercise heart rate, then aim to get within a specific lower and upper percentage of this maximum), but this was tweaked by the cardio nurses for each individual depending on how we'd performed during exercise sessions within the course.

This then feeds through into the NHS exercise guidelines. Unless there are specific medical reasons we should be aiming for a minimum of 150 minutes per week of exercise at this level. For me the target is to get roughly in the range 105-135 beats per minute and then hold this for at least thirty unbroken minutes, this to be performed a minimum of five times each week.

It quickly became clear that these NHS guidelines are pretty demanding. The hard reality is that for a lot of people, especially with full time jobs or with families to look after, it's going to be extremely challenging to hit these targets. Especially when you add the fact that as heart patients we need to be meticulous about warm-up and cool-down periods. Roll it all up and I'm spending over an hour in the gym for each session, and completing five sessions per week. Set in the context of our modern lives, that's a big ask!

The other thing that's struck me is that a combination of beta blockers, plus a couple of years of regular exercise since my bypass surgery, now means that exercise really does mean exercise! Walking on the flat, no matter how fast, won't get me up to my 105 bpm threshold, nor will most gardening tasks short of continuous digging, and housework doesn't even move the needle. My wife and I do quite a lot of dancing, and again it's sobering just how much work is required to meet the NHS exercise targets. Most ballroom dances won't even come close to the 105bpm minimum, and it really needs quite a vigorous dance like a salsa or a jive to qualify as "real" exercise. But then we hit the problem of maintaining this for at least thirty unbroken minutes. Dancing doesn't work like this, there's a break between each number and dances often alternate between faster and slower numbers, so maintaining thirty plus unbroken minutes within the target heart rate range rarely happens in practise.

I've found that to hit the recommended NHS minimums I really need the kind of aerobic work-outs that we're only likely to find in a gym or in front of the telly with an exercise video! It would be nice to think that exercise can be integrated into every day life, but that's not been my experience. Perhaps it's do-able for a bit of basic mobility training or burning a few extra calories to assist with weight loss, but strengthening the heart muscle to the levels recommended by the NHS seems to require a different order of commitment.

As I said earlier, I'm acutely conscious of how hard many people will find this, but unfortunately heart disease doesn't really care too much about our personal challenges, we either tick these boxes or we don't.

Good luck!

[devonian186 in reply to Chappychap]

Going to the gym or swimming regularly is not realistic for many people and jogging is not appealing to many, especially in bad weather. Walking is something that most people can readily do without masses of equipment or huge commitments of time.

However to step up your rate of walking I would suggest a pair of hiking poles. They naturally increase your pace and get your arms swinging in an aerobic fashion. I try to do 10000 steps a day of which 25/30 minutes will be with poles, so making the theoretical weekly exercise amounts. If you can include some uphill walking in that, all the better, and off pavement walking as well. On pavement walking uses the rubber ferrules on the pole tips and to walk across grass generally remove them so the points dig in.

Poles are around £10 each for modest ones if you just want to see if this sort of exercise suits you, right up to £40 or so for good ones, with a device to absorb the pressure

[Hidden]

With the caveat that I’m not medically qualified. Although 60 to 100bpm is the oft-quoted normal, in practice it’s more like 50 to 100bpm is considered healthy at rest by medics, albeit relative to what’s normal for you, and assuming that you feel ok if you are below 60bpm: many people routinely sit below 60bpm at rest and feel fine, myself included. In terms of the reduction beta blockers will cause, it’ll vary somewhat from person to person, and dose is also relevant, but my understanding is there’s an expectation that beta blockers will reduce resting hr by roughly 10bpm on average. So not a massive drop unless you’re already at the low end of normal to begin with. But even then, it will depend on how you feel, and what the medics’ views are as to your heart function. Bottom line: if your resting rate has dropped below 60 as a result of taking medication and it’s concerning you, speak to a medical professional.

[Avdi]

My heart rate since childhood and prior to a double bypass in May 2022 was anywhere from 52 to 60 bpm at rest. Since my bypass and 2.5mg of Bisoprolol daily it is 45 to 55 at rest sometimes dropping down to 40 if I’m couch potatoeing, it has been in the mid 30s when I’m sleeping.

Apart from being tired at times everything is fine, I walk 8 to 10 miles 3 or 4 times a week and at least 3 miles daily.

As everyone has said, individually we are all different and your “new” normal will be what it is. Take care.

[DanniC88]

Ahh the old 150 minutes a week! I was asked to do this by my cardiologist 6 months ago and yoga as a cure to my heart condtion. Along with no booze, no fags, no coffee, and no stress.I dont smoke and haven't for 4 years, I dont drink at all, I have only decaff, and of course I stress I have 3 autistic children under 10 years old. He said tough find time. I said I have a treadmill and like to walk at a good pace for roughly 30-45 a day. Not good enough he says.

If I dont do it he will increase my bisoprolol. Thats a threat more than a cure🙄🙄

[Leythersrus1]

Mine is 50 to 60 sometimes 45.

[Charl70]

hi there since being on beta blockers my bpm averages around 60 to 65 bpm even after cardio exercises it's around 70

[Harefieldfan]

mine averaged around 54 bpm. Used to be 72. I’ve got used to it and am managing 45 mins a day on exercise bike, burning 300 calories. I’m 78.

[DANMAN5]

have just been put onto beta blockers and the GP recently upped the dose to 5mg daily. They do seem to make the breathlessness worse though ,so I have stopped taking them until I next see the GP.

[Judithdalston in reply to DANMAN5]

I’ve only just got an inhaler to ward off bisoprolol breathlessness….supposed to take it 10 mins before exercise or whatever triggers it, but haven’t worked out what triggers it, most obvious is cooking ontop of the stove ie positional as arms raised! Odd.

[tunybgur]

I was put on 1.25mg bisoprolol after heart attack and my resting pulse dropped from 55 to 45, and my BP dropped from 115/70 to 105/70, but we're all different and react differently to meds.

Good luck

[devonian186]

I had a quadruple heart bypass at 70 and I certainly couldn't jog before and could not do so now.

At no time did my cardiologist suggest I swim or jog or go to the gym and I did ask. He was very happy with generally being active, sensible walking, sometimes at speed and up hills. I have never liked swimming and there is no pool near enough to make it worthwhile. Also to keep weight sensible and have a good diet.

[devonian186]

"....but 70 is not that old these days"

Please tell where I should send my large Christmas present to you!

[wischo]

There is a guy I know who is 96 yrs old who can drive from the UK to Germany to participate in a sporting event but to be honest this is a really rare event and more down to genetics than the will to do so. He would be the only person I know of near that age group that can do that so that makes him a rarity. Fair play to your ability to jog 5 times a week but really you are just 64 and I know you will more than likely slow down significantly should you reach your 70s. I am 72 and also can not jog as my knees and feet suffer as is so common when we are getting old so I walk 4 to 6 miles daily, do some upper body weights and as above try to hit at least 10,000 steps daily. Neither do I follow some amazonian plant diet but rather enjoy what I eat and also have a few beers at weekends and by a few I do mean 2 or 3 bottles Saturday and Sunday night. Devonian186 is doing his upmost to sustain a healthy lifestyle and his cardiologist told me exactly the same as him, no mad diets as your not carrying much weight, walking is a brilliant exercise regime, and enjoy a few beers so long as there are no felt ill effects. My point is people have their own ways of dealing with heart issues and really do not need to be told what they are capable or incapable of.

[wischo]

So very true as all my children including myself have resting heartrates in the 50s with no symptoms between us. Had it checked and was told that Bradycardia is now only considered if your BPM is below 50 or you have symptoms. Of course athletical people can go into the 40s safely.

[pablojack]

Apologies since my answer is not specific to beta blockers. After cardio version for atrial flutter my resting heart rate dropped from mid 60 to 46. I suspect such a drop is not unusual with caedioversion but I cannot find any discussion on the subject. However this ruled out beta blockers in my case.

I exercise 3 times a week and can reach a max heart rate of mid 120. Some people would describe they as a maximum reserve of 80BPM similar to someone with a rating heart rate of 70and a max rate of 150. I cannot find anything definitive on this subject.

Nevertheless since I have never had any symptoms and my heart responds to vigorous exercise as a "normal" heart then I will continue with my current regime.

Best wishes.

[wischo]

Its called arthritis. If you can tell me how to prevent it please do, Osteo arthritis not from being overweight but just happens to a substantial amount of people as we age.

[firstlight40]

Bisoprolol is used to slow the heart and particularly to help your heart recover after a heart attack. I was prescribed it after my NSTEMI HA and my heart rate which was about 60 dropped to 48. This was considered a bit low by the cardiologist and so since no damage to my heart was found and it slowed me down a bit too much I was taken off it.