Any physicians out there?

In article <[email hidden]>,

mike said:

I have a question about calcium channel blockers and exercise endurance. Is
there anyone who could help answere questions I have?

Thanks, Mike

Just ask the guys at the gym. I'm sure they can help.

--
Michael Press

mike said:

I have a question about calcium channel blockers and exercise endurance. Is
there anyone who could help answere questions I have?

Thanks, Mike

There are exercise physiologists and a couple of physicians here, but
as they have not answered yet I would hazard a guess that since this
class of drug lowers cardiac output I would expect that it would
decrease power output. It lowers blood pressure too, so it may have
some effect on perfusion of the muscles--but this is just a guess. Hope
you get a more authoritative answer.

Steve

Already tried, all I get is people wondering what the hell I'm talking
about..

"Michael Press" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

In article <[email hidden]>,

mike said:

I have a question about calcium channel blockers and exercise endurance.
Is
there anyone who could help answere questions I have?

Thanks, Mike

Just ask the guys at the gym. I'm sure they can help.

--
Michael Press

Hi Mike - I am a doc with a background in surgical critical care and
clinical pharmacology (and a Cat IV packfill masters racer.) Not much
is written about calcium channel blockers and effect on aerobic
exercise as an overall topic - your question prompted me to a Pubmed
search and there were no papers directly addressing this. What are
your specific questions ?
In brief, the most important things to know are:

1) What disease you're taking them for
2) What other meds, medical history, etc. you take/have
3) Your cycling habits/goals - are you a recreational cyclist who
never sees HRZ IV or V or are you a racer ?

I can't promise definitive answers, but if you have simple
hypertension and are otherwise healthy and want to race, there are
better classes of drugs for you. If you are a recreational rider with
hypertension, they're probably fine. If you have ventricular
dysfunction or angina, it's a whole different ball game. Hit me with
some specifics, and I'll give you my best answers. if I don't know,
I'm not an Internet pundit and won't throw out arbitrary opinions. Not
that anyone does that on this newsgroup.

Lou D'Amelio

Hi, thanks for responding. My blood pressure for some reason has been very
high (SBP~180). It always ran in the 110 range so I am not sure what
changed. There is a family history though and I am 49. Now, I'm not a racer
but am in pretty good condition otherwise. My heart rate is very high most
of the time (90's) since starting 20mg Sular though my pressure is back to
the 110's. HR had been 50's to 60's prior. I also take 10mg lisinopril.
Needless to say, my exercise tolerance is way down. The only thing that has
changed is this drug. It is early in the season but I can't reconcile all of
this to poor fitness on the bike. I am a recreational rider but pretty
serious and love hills rather than intervals as there are plenty on my
route. I ride 25-30 miles 2-3 times per week. At any rate, the biggest hill
on my route is about a 20% grade for 1/2 mile. Normally, I see ~185 HR by
the top. I haven't even touched this one yet because I reach that point on
hills much shallower and shorter.

A second question; is it possible that my heart rate was previously low due
to hypertension that I was unaware of? But if my pressure was high before
with a lower heart rate why didn't this affect exercise tolerance? Wouldn't
my cardiac output be lower with the low heart rate? I really appreciate any
help you can provide.

"Lou D'Amelio" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Hi Mike - I am a doc with a background in surgical critical care and
clinical pharmacology (and a Cat IV packfill masters racer.) Not much
is written about calcium channel blockers and effect on aerobic
exercise as an overall topic - your question prompted me to a Pubmed
search and there were no papers directly addressing this. What are
your specific questions ?
In brief, the most important things to know are:

1) What disease you're taking them for
2) What other meds, medical history, etc. you take/have
3) Your cycling habits/goals - are you a recreational cyclist who
never sees HRZ IV or V or are you a racer ?

I can't promise definitive answers, but if you have simple
hypertension and are otherwise healthy and want to race, there are
better classes of drugs for you. If you are a recreational rider with
hypertension, they're probably fine. If you have ventricular
dysfunction or angina, it's a whole different ball game. Hit me with
some specifics, and I'll give you my best answers. if I don't know,
I'm not an Internet pundit and won't throw out arbitrary opinions. Not
that anyone does that on this newsgroup.

Lou D'Amelio

On May 5, 12:35 am, "mike" <[email hidden]>

Quoted message said:

Hi, thanks for responding. My blood pressure for some reason has been very
high (SBP~180). It always ran in the 110 range so I am not sure what
changed. There is a family history though and I am 49. Now, I'm not a racer
but am in pretty good condition otherwise. My heart rate is very high most
of the time (90's) since starting 20mg Sular though my pressure is back to
the 110's. HR had been 50's to 60's prior. I also take 10mg lisinopril.
Needless to say, my exercise tolerance is way down. The only thing that has
changed is this drug. It is early in the season but I can't reconcile all of
this to poor fitness on the bike. I am a recreational rider but pretty
serious and love hills rather than intervals as there are plenty on my
route. I ride 25-30 miles 2-3 times per week. At any rate, the biggest hill
on my route is about a 20% grade for 1/2 mile. Normally, I see ~185 HR by
the top. I haven't even touched this one yet because I reach that point on
hills much shallower and shorter.

A second question; is it possible that my heart rate was previously low due
to hypertension that I was unaware of? But if my pressure was high before
with a lower heart rate why didn't this affect exercise tolerance? Wouldn't
my cardiac output be lower with the low heart rate? I really appreciate any
help you can provide.

"Lou D'Amelio" <[email hidden]> wrote in message

news:[email hidden]...

Quoted message said:

Hi Mike - I am a doc with a background in surgical critical care and
clinical pharmacology (and a Cat IV packfill masters racer.) Not much
is written about calcium channel blockers and effect on aerobic
exercise as an overall topic - your question prompted me to a Pubmed
search and there were no papers directly addressing this. What are
your specific questions ?
In brief, the most important things to know are:

Quoted message said:

1) What disease you're taking them for
2) What other meds, medical history, etc. you take/have
3) Your cycling habits/goals - are you a recreational cyclist who
never sees HRZ IV or V or are you a racer ?

Quoted message said:

I can't promise definitive answers, but if you have simple
hypertension and are otherwise healthy and want to race, there are
better classes of drugs for you. If you are a recreational rider with
hypertension, they're probably fine. If you have ventricular
dysfunction or angina, it's a whole different ball game. Hit me with
some specifics, and I'll give you my best answers. if I don't know,
I'm not an Internet pundit and won't throw out arbitrary opinions. Not
that anyone does that on this newsgroup.

Quoted message said:

Lou D'Amelio- Hide quoted text -

- Show quoted text -

Hi Mike
Can't remember what I was on for a while but they absolutely killed
my ability to train. It was instantly like I was limited to about
60-70% of what I could do before, or without them. Luckily I found an
MD who understood since they were a runner and changed them to
something else for me. Now I discuss this with my Docs as one of the
girst questions I have. I'm taking Norvasc and Lisynopril Hctz which
seem to be ok for me. I'm still massively overweight but they've got
my BP down from always over 160/120 which it was when I was 16 and
165lbs to 125-135/80-90 with no negatives that I can currently see.
Bill C

Hi Bill,

Thanks for the input. I am in need of something else I think. This drug may
not have anything to do with it but seems suspicious. I started out on
lopressor which did next to nothing for my BP and I couldn't get my heart
rate above 130 ever. Talk about killing the ability to train! Then I started
the lisinopril and the dose kept increasing without much effect on my BP
either. That's when he started the Sular. It has done wonders for the BP
but... Seems that being in shape isn't a complete cure for getting older. If
I weren't in shape though I would probably be much worse off. Anyway, there
is a doc that responded to this thread and I am anxious to see what he has
to say. Thanks again and enjoy your summer.

Mike

"Bill C" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

On May 5, 12:35 am, "mike" <[email hidden]>

Quoted message said:

Hi, thanks for responding. My blood pressure for some reason has been
very
high (SBP~180). It always ran in the 110 range so I am not sure what
changed. There is a family history though and I am 49. Now, I'm not a
racer
but am in pretty good condition otherwise. My heart rate is very high
most
of the time (90's) since starting 20mg Sular though my pressure is back
to
the 110's. HR had been 50's to 60's prior. I also take 10mg lisinopril.
Needless to say, my exercise tolerance is way down. The only thing that
has
changed is this drug. It is early in the season but I can't reconcile all
of
this to poor fitness on the bike. I am a recreational rider but pretty
serious and love hills rather than intervals as there are plenty on my
route. I ride 25-30 miles 2-3 times per week. At any rate, the biggest
hill
on my route is about a 20% grade for 1/2 mile. Normally, I see ~185 HR by
the top. I haven't even touched this one yet because I reach that point
on
hills much shallower and shorter.

A second question; is it possible that my heart rate was previously low
due
to hypertension that I was unaware of? But if my pressure was high
before
with a lower heart rate why didn't this affect exercise tolerance?
Wouldn't
my cardiac output be lower with the low heart rate? I really appreciate
any
help you can provide.

"Lou D'Amelio" <[email hidden]> wrote in message

news:[email hidden]...

Quoted message said:

Hi Mike - I am a doc with a background in surgical critical care and
clinical pharmacology (and a Cat IV packfill masters racer.) Not much
is written about calcium channel blockers and effect on aerobic
exercise as an overall topic - your question prompted me to a Pubmed
search and there were no papers directly addressing this. What are
your specific questions ?
In brief, the most important things to know are:

Quoted message said:

1) What disease you're taking them for
2) What other meds, medical history, etc. you take/have
3) Your cycling habits/goals - are you a recreational cyclist who
never sees HRZ IV or V or are you a racer ?

Quoted message said:

I can't promise definitive answers, but if you have simple
hypertension and are otherwise healthy and want to race, there are
better classes of drugs for you. If you are a recreational rider with
hypertension, they're probably fine. If you have ventricular
dysfunction or angina, it's a whole different ball game. Hit me with
some specifics, and I'll give you my best answers. if I don't know,
I'm not an Internet pundit and won't throw out arbitrary opinions. Not
that anyone does that on this newsgroup.

Quoted message said:

Lou D'Amelio- Hide quoted text -

- Show quoted text -

Hi Mike
Can't remember what I was on for a while but they absolutely killed
my ability to train. It was instantly like I was limited to about
60-70% of what I could do before, or without them. Luckily I found an
MD who understood since they were a runner and changed them to
something else for me. Now I discuss this with my Docs as one of the
girst questions I have. I'm taking Norvasc and Lisynopril Hctz which
seem to be ok for me. I'm still massively overweight but they've got
my BP down from always over 160/120 which it was when I was 16 and
165lbs to 125-135/80-90 with no negatives that I can currently see.
Bill C

Hi - brief answers as I have to run out the door - you increased heart
rate may be due to vasodilation from your Sular. You may do better (as
a cyclist) with a lower dose of Sular and a higher dose of lisinopril
which would likely control your BP while maintaining a lower resting
heart rate. Given the sudden change in your BP, also make sure your
physician checks you for a discrete cause of hypertension, including
renal artery stenosis, catecholamine-producing adrenal tumors, and
hyperthyroidism. You probably don't have any of these, but any sudden-
onset or accelerated hypertension bears a good look for an underlying
cause.

Your previously low heart rate doesn't wasn't from your hypertension.
HTN doesn't produce a low heart rate. Your low resting HR was probably
from the increased stroke volume (amount of blood ejected per beat)
that goes along with fitness.

Try to find a cardiologist or at least a good internist with an
appreciation of the unique needs of athletes. There aren't many
around. At a minimum, find someone who will listen to your concerns
about lifestyle and activity and not just prescribe by rote to get the
numbers down.

Given your significant hypertension and age, it would be prudent to
have at least a stress test if not non-invasive coronary imaging
before pushing yourself to threshhold heart rates.

Hope this helps somewhat..............lou D'Amelio

In article <[email hidden]>,

Bill C said:

On May 5, 12:35 am, "mike" <[email hidden]>
wrote:

Quoted message said:

Quoted message said:

of the time (90's) since starting 20mg Sular though my pressure is back to
the 110's. HR had been 50's to 60's prior. I also take 10mg lisinopril.
Needless to say, my exercise tolerance is way down. The only thing that has
changed is this drug. It is early in the season but I can't reconcile all of
this to poor fitness on the bike.

Quoted message said:

Hi Mike
Can't remember what I was on for a while but they absolutely killed
my ability to train. It was instantly like I was limited to about
60-70% of what I could do before, or without them. Luckily I found an
MD who understood since they were a runner and changed them to
something else for me.

I had a similar fitness issue with something I was taking over the
winter.

Wait, those were donuts.

At least the UCI doesn't test for donuts,

--
Ryan Cousineau [email hidden] http://www.wiredcola.com/
"I don't want kids who are thinking about going into mathematics
to think that they have to take drugs to succeed." -Paul Erdos

Ryan Cousineau said:

In article <[email hidden]>,
Bill C <[email hidden]> wrote:

It was instantly like I was limited to about

Quoted message said:

Quoted message said:

60-70% of what I could do before, or without them. Luckily I found an
MD who understood since they were a runner and changed them to
something else for me.

I had a similar fitness issue with something I was taking over the
winter.

Wait, those were donuts.

At least the UCI doesn't test for donuts,

--
Ryan Cousineau [email hidden]://www.wiredcola.com/
"I don't want kids who are thinking about going into mathematics
to think that they have to take drugs to succeed." -Paul Erdos

Might of been a good thing because at 60-70% I couldn't beat the
local cops to the donuts anymore. ;-)
Bill C

Then you haven't heard of the new ones that come with caffeine lol. It's
only a matter of time until they're laced with ...

"Ryan Cousineau" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

In article <[email hidden]>,

Bill C said:

On May 5, 12:35 am, "mike" <[email hidden]>
wrote:

Quoted message said:

Quoted message said:

of the time (90's) since starting 20mg Sular though my pressure is back
to
the 110's. HR had been 50's to 60's prior. I also take 10mg lisinopril.
Needless to say, my exercise tolerance is way down. The only thing that
has
changed is this drug. It is early in the season but I can't reconcile
all of
this to poor fitness on the bike.

Quoted message said:

Hi Mike
Can't remember what I was on for a while but they absolutely killed
my ability to train. It was instantly like I was limited to about
60-70% of what I could do before, or without them. Luckily I found an
MD who understood since they were a runner and changed them to
something else for me.

I had a similar fitness issue with something I was taking over the
winter.

Wait, those were donuts.

At least the UCI doesn't test for donuts,

--
Ryan Cousineau [email hidden] http://www.wiredcola.com/
"I don't want kids who are thinking about going into mathematics
to think that they have to take drugs to succeed." -Paul Erdos

A good internist is a great idea. I do believe that my doc is more concerned
with moving volume through his office and he rarely tests for anything. Not
that I've had that many issues. He doesn't even routinely prescribe for
cholesterol testing. I always have to ask. Thanks for the input. I
appreciate your time an d thoughtfulness. I've got a good doc in mind but he
rarely accepts new patients. He stays that busy because he is good I
suppose.

Mike

"Lou D'Amelio" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Hi - brief answers as I have to run out the door - you increased heart
rate may be due to vasodilation from your Sular. You may do better (as
a cyclist) with a lower dose of Sular and a higher dose of lisinopril
which would likely control your BP while maintaining a lower resting
heart rate. Given the sudden change in your BP, also make sure your
physician checks you for a discrete cause of hypertension, including
renal artery stenosis, catecholamine-producing adrenal tumors, and
hyperthyroidism. You probably don't have any of these, but any sudden-
onset or accelerated hypertension bears a good look for an underlying
cause.

Your previously low heart rate doesn't wasn't from your hypertension.
HTN doesn't produce a low heart rate. Your low resting HR was probably
from the increased stroke volume (amount of blood ejected per beat)
that goes along with fitness.

Try to find a cardiologist or at least a good internist with an
appreciation of the unique needs of athletes. There aren't many
around. At a minimum, find someone who will listen to your concerns
about lifestyle and activity and not just prescribe by rote to get the
numbers down.

Given your significant hypertension and age, it would be prudent to
have at least a stress test if not non-invasive coronary imaging
before pushing yourself to threshhold heart rates.

Hope this helps somewhat..............lou D'Amelio

"mike" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

A good internist is a great idea. I do believe that my doc is more
concerned with moving volume through his office and he rarely tests for
anything. Not that I've had that many issues. He doesn't even routinely
prescribe for cholesterol testing. I always have to ask. Thanks for the
input. I appreciate your time an d thoughtfulness. I've got a good doc in
mind but he rarely accepts new patients. He stays that busy because he is
good I suppose.

Chances are that your physician's concern in moving volume through his
office isn't as great as that of his group administrators.

In all fairness, you're probably right. Plus, the way reimbursements are
these days, he has to do that to stay afloat. The problem is though that the
patient is the one who suffers. The only one who wins is the insurance
company.

"Carl Sundquist" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"mike" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

A good internist is a great idea. I do believe that my doc is more
concerned with moving volume through his office and he rarely tests for
anything. Not that I've had that many issues. He doesn't even routinely
prescribe for cholesterol testing. I always have to ask. Thanks for the
input. I appreciate your time an d thoughtfulness. I've got a good doc in
mind but he rarely accepts new patients. He stays that busy because he is
good I suppose.

Chances are that your physician's concern in moving volume through his
office isn't as great as that of his group administrators.

In article <[email hidden]>,

mike said:

"Carl Sundquist" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Quoted message said:

Chances are that your physician's concern in moving volume through his
office isn't as great as that of his group administrators.

Quoted message said:

In all fairness, you're probably right. Plus, the way reimbursements are
these days, he has to do that to stay afloat. The problem is though that the
patient is the one who suffers. The only one who wins is the insurance
company.

It's the insurance company's shareholders who are the real winner.
You own stock in them, right? So even if you can't get into this
doctor's office, you're still a winner!

--
tanx,
Howard

Never take a tenant with a monkey.

remove YOUR SHOES to reply, ok?