Beta blockers and performance

Nutrition
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Disclaimer: I am not seeking medical advice. What I am looking for is credible journal articles or research around beta blockers and exercise performance - specifically Carvedilol/Coreg - that I can use to form questions to ask my doctor.

I know beta blockers suppress heart rate and adrenal response. I am wondering if that may limit my performance, VO2 max, etc. I have found conflicting research on this, and am looking for clarity. Priority is to continue protecting my heart and vascular system, but maybe there’s a different drug more suitable for athletic endeavors that I could ask my doctor about.

Thanks.

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I don’t have the answer but have heard the same. Please advise any info towards this subject. Thank s brother

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Alright, so it took me several hours of dedicated internet sleuthing to find some answers. There is a surprising dearth of information on this topic, and what I could find was somewhat inconclusive. Several scholarly articles, including a meta analysis of other articles showed a weak or no link between beta blockers and maximum VO2, aerobic performance, or time to exhaustion. Others found a more significant link between those two.

In my case, I asked my cardiologist about this, and he agreed to cut my dose in half. He indicated “beta blockers do reduce peak aerobic performance.” I do not have diagnosed hypertension, but occasionally my BP pushes into the 120+/80+ range and we’re trying to keep that as low as possible. This is a result of genetics, as I eat a healthy diet that is low in sodium. (My wife is a Registered Dietician and holds a PhD in Nutrition Science, so I feel confident claiming this…)

Should be noted this is not medical advice, and always talk to your doctor before making any changes. Here are some sources I found that appear to be credible:

-Exercise performance and beta-blockade - PubMed
-https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=5732&context=masters_theses
-https://www.nature.com/articles/1002173.pdf?origin=ppub
-Athletes and High Blood Pressure
-https://www.acc.org/~/media/clinical/pdf-files/approved-pdfs/2012/03/21/10/04/bethesdaconference36.pdf

I’m riding the B2 ZRL Division this season, so I hope to have some data and before/after results to share soon.

:v:

1 Like
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I’ve been taking Metoprolol for the last 10 years because I have a history of AFib. The dosage is very low, 12.5mg twice a day. But even with that, I find that my max HR is about 10-15 bpm lower for up to about six hours after taking a dose. My FTP is also lower by about 20%. These are estimates because I rarely ride hard with the beta blocker in my system. I’m a cat 2 masters 60+ road racer and also do Zwift races; I’m currently doing ZRL B1 races on Tuesdays and the WTRL TTT on Thursdays.

I work around the beta blocker effects as follows:

  • On race days I stop taking metoprolol 12 - 24 hours before the event
  • Morning hard training ride or long endurance ride - skip morning dose
  • Evening training ride - might skip morning dose, depends on workout intensity
  • Recovery ride or social ride - normal AM dosage

Riding with beta blocker in my system is like riding at high altitude - I feel like I’m not getting enough oxygen, everything hurts a little more, and my motivation is low.

My cardiologist isn’t exactly thrilled about playing it fast and loose with the beta blocker schedule, but he knows how important bicycle racing is to me and thinks that the physical and mental benefits outweigh the risks.

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Clark,

Thanks for sharing! I was on Coreg 12.5 twice daily, and now it’s 6.25 twice daily. My max HR should be north of 180, but rarely hits 160 on rides. I too have noticed that being off the meds for 12-24 hours leads to an increase in HR.

I 100% agree with your assessment of riding with a full beta blocker dose. I find it very difficult to hold even threshold efforts for more than a couple minutes at a time. I’m racing ZRL B2 East, and typically can only hold wheels in the front pack for a minute or two at the start of the race.

Have you noticed that you are able to make gains in FTP even on the beta blockers? I have been stuck at roughly the same FTP for more than 18 months, despite riding more miles, more hours, at a higher intensity during that time. Have also been following FasCat plans since March. I’m not expecting an overnight bump of 20% in my FTP just by being off beta blockers, but am curious about your observations. I have been on various doses of Coreg since 2015.

Thanks, again. And good luck in ZRL!