11d (edited) • Body
Heart Rate Metrics
Taking a beta blocker for blood pressure or other conditions impacts heart rate interpretation when exercising. My coach, an ultrarunner, reminded me of using watts or RPE as a better alternative.
TL;DR: If you take a beta blocker, your heart rate is artificially low. Not a little. Sometimes 20 to 30 percent. That means your fitness tracker, your target heart rate zones, and every calorie and recovery number built on top of them are wrong. Your body is working just as hard. The gauge is broken, not the engine. Stop training to a number and start training to effort.
Beta blockers work by blunting the signal that tells your heart to speed up. Blood pressure comes down, workload on the heart comes down, and for a lot of people that is exactly the point. The side effect nobody mentions at the pharmacy counter is that your heart rate stops being an honest reporter of how hard you are working. Your resting rate drops. Your working rate drops. Your peak drops, often by a large margin. Meanwhile the actual metabolic demand of the exercise has not changed at all. You are doing the same work with a quieter dashboard.
Here is where it gets dangerous, and I mean that literally. Every heart rate zone chart on every treadmill in America starts with 220 minus your age. If you are 55, that says your max is 165. On a beta blocker, your real ceiling might be 130. Now you are on a bike chasing 148 for your interval, and 148 does not exist. You cannot get there. So you push harder. And harder. You are not hitting a target, you are hunting a ghost, and you will bury yourself trying. The same math runs in reverse on the easy end. An effort that reads as gentle on the watch may be near your actual limit.
The fix is to stop outsourcing the judgment. On a bike, use watts. Power is external work and no medication touches it. Everywhere else, use rate of perceived exertion on a one to ten scale, or the talk test. Can you speak a full sentence? Moderate. Three words? Hard. If you want a real number instead of a guess, ask for a CPET. A formal exercise test measures your actual peak heart rate on your actual medication and gives you zones that mean something. It also tells you what your heart is doing under load, which if you are on a beta blocker, someone already decided was worth knowing.
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Heart Rate Metrics
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