Is there a site that you guys use to help me determine if a peson's medication is causing HR to be lowered? I know beta blockers do this and some Blood Pressure medicines too. I have a client on this bp medicine
and he has a pretty low RHR (50) considering his condition, age, etc. He said this was taken with his HR monitor on. His old trainer had him working out at 160 or better and he says he has a hard time getting there. I am thinking it should be easier for him.
I am just wanting to check things out on this one and am not finding any conclusive data to support my suspicions one way or the other? It would be highly useful if there was a site that I could reference for these questions.
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I don't have a site for you but lisinopril is an ACE inhibitor it shouldn't affect heart rate. The beta blockers and digoxin/lanoxin and some antiarrhythmics would be the biggest culprits.
He never had his HR monitored before?
Low HR can just be a normal thing for someone.. even before doing any sports, 40bpm when standing around was normal for both me & my brother (teenager). Even now (am 45), 50bpm at rest (40bpm as waking RHR) is totally normal and I'd say that at 50yrs I still expect it to be in the high 40s/low 50s.
I don't have a site for you but lisinopril is an ACE inhibitor it shouldn't affect heart rate. The beta blockers and digoxin/lanoxin and some antiarrhythmics would be the biggest culprits.
Is there a site that you guys use to help me determine if a peson's medication is causing HR to be lowered?
You are not a doctor so don't try to play one to your client. Tell him to see his doc if there is a possible issue with medication.
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Working "hard," or the perception of working hard, doesn't really mean anything. Sweating, vomiting, and breathing hard could be a good workout or a tropical disease kicking in.-Dan John
Thanks for the opinions folks, that matches my reasearch too.
Not trying to play Doctor Kuri but don't want to be an alarmist either. Just trying to make sure that I am not overlooking anything. I have an older (over 45) year old obese man with a RHR of 50, complaining that he cannot get into a higher heartrate zone and he is on this BP medicine. Before I prescribe HR Zones for HIIT work or any cardio work I want to make sure that his medication is not interfering with his natural HR. I could not find anything in my research on the medication that he is specifically taking that conclusively stated that it did alter HR but there was a lot of "hinting" that there could possibly be a side affect from certain types of similar medications. So that still leaves me uncertain...
I am simply wondering if there is a site somewhere that you guys use and trust that is fairly simple to use and gives these kinds of answers even if it is a paid for site.
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The BIGGER I get the smaller you look
Telling an obese person on BP meds that has issues with HR to see their doc is damn far from alarmist. No matter what you think you can find in your research it is not a replacement for having a doc check him out.
Or go ahead and have him do HIIT work regardless and have a possible catastrophy on your hands.
That's the kind of shit that gives all trainers a bad reputation.
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Working "hard," or the perception of working hard, doesn't really mean anything. Sweating, vomiting, and breathing hard could be a good workout or a tropical disease kicking in.-Dan John
Telling an obese person on BP meds that has issues with HR to see their doc is damn far from alarmist. No matter what you think you can find in your research it is not a replacement for having a doc check him out.
Or go ahead and have him do HIIT work regardless and have a possible catastrophy on your hands.
That's the kind of shit that gives all trainers a bad reputation.
Uh... thanks for the help...
Kuri, I am NOT telling him to do anything yet so please don't judge me for someone who isn't trying to do the right thing. I am simply looking for a definitive source for this sort of information BEFORE I make a recommendation either way just in case there is a resource out there that I wam missing. If one doesn't exist, that is fine. I did not know. Of course barring this I will use common sense.
FYI: In our gym we use RPE for all forms of cardio with all our clients as a rule anyway so safety measures are in place against this sort of catastrophy anyway.
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The BIGGER I get the smaller you look
Karla,
You're not being an alarmist...you're being investigative. Good for you.
If I were you in this position, I'd do away with giving him heart rates numbers as a guage. I stopped using heart rate as an indicator a long time ago. Instead of giving him the ever popular "HIIT" that we like to use sooooo loosely, I suggest just give him very lite interval training. And instead of heart rate, use RPE's. Better scale... and in my opinion, gives you more feedback than HR. Feedback from the client...which is more important to me than a digital number on a wristwatch or machine.
Sounds crazy right? I mean, how the hell did Polar become this millionaire company making these chest straps?
For your first session with your obese client, pick his speeds on the treadmill (or wherever you have him) and use a RPE scale to fixate his intervals. For instance: 2 minutes at an RPE of 5 1 minutes at an RPE of 8
and so on...
Teach him what signs to look for at a RPE higher than 8, and this way, you can both be aware of the feedback from the activity.
Sorry, I don't have any links to share...just that damn experience again.
LOL! John that is exactly how I did it and am doing it. I always make everyone use RPE (I use old Borg) to start with. We use the "turn your head and talk test" from ACSM at the hard-working level for a check.
The problem is that he comes from another trainer who had him using a HR monitor so he is attached to that thing now and the other trainer gave him specifics. Actually the guy told him to do cardio in the range above 160 for an hour a day. The client says it is hard for him to get into that range thus all the investigation. I fear that no matter what I teach him about RPE he will want to translate that to HR and his toy. I have the formulas to help him do this but got suspicious when he told me his RHR. So I came here looking for some sort of reference site that you guys use to match medicines to possible side affects. There are so many sites and some of the conflict a bit...
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The BIGGER I get the smaller you look
I don't think ignoring HR is the best idea, particularly in this instance. Yes, you should watch for physical signs, but RPE is not something you can set as standard for all people.
Its not the clients job to look for signs and to relay you when they are about to fall flat on their face, it is yours and if smart, and method of measure.
But then you would never see me putting a obese person through HIIT or anything remotely close in the first place. Turn off The Biggest Loser.
Have you manually checked his heartrate? Sometimes heartrate monitors don't accurately reflect the true heartrate (just as an apical rate can differ from a radial pulse).
Do you know how to check someone else's heart rate?
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Guys let me clarify something here so that I don't get killed too much more. The HIIT to which I refer is not what you are thinking. I may have the terminology wrong but it is what is used at the training gym where I work. Beginners get an intro to this form of cardio in the following manner....
5 min at RPE of very easy to easy,
5 min at RPE of somewhat hard (take 2 min to get there spend 1 min in the zone and 2 min to come back down)
So bascially it is ss cardio with some introductory Interval concepts.
I drive over an hour to work at this gym. I had 4 different offers on my plate and one of them was from a gym less than 1 mile from my work. The sports therapy gym where I chose to work has a pretty good head trainer (degree, head of pro-baseball team, etc), lots of continuing education options for me and the head trainer keeps a very close eye on his newbies (why I am there). Net is I don't think I am going to hurt anyone with gross mistakes. In hindsight I probably should have just waited until I worked again and talked to him about this. I really was just looking for a medicine reference site and thought it would be a binary.
I do not intend to ignore his HR and I do not have TV so no Biggest Loser influence here. So Leigh, would you have this person consult their Dr on this specific medicine or not?
Thanks Julie I have not yet done this but I can do it no problem. I have only seen him one time so far and will not see him again until next week.
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The BIGGER I get the smaller you look
I don't think ignoring HR is the best idea, particularly in this instance. Yes, you should watch for physical signs, but RPE is not something you can set as standard for all people.
RPE doesn't have to be a standard for anything...simply a tool for feedback. Could be used in addition too HR also. The simpler and easier to use, the MORE it is used--which equals more self awareness. It all depends on the level of comfort the trainer has with a specific special pop. client. New trainers (as I assume Karla is) will always be less comfortable.
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Its not the clients job to look for signs and to relay you when they are about to fall flat on their face, it is yours and if smart, and method of measure.
It is the trainer's job to educate the client for unforeseen changes in the body during progressive activity. Not every trainer will be around their client 24/7 (in or outside the gym). I am all about teaching my clients and readying them with expectations (especially if they come with contradictions as Karla's client seems to have). Falling flat on their face is a result of poor programming, not having them use RPE instead of HR. That's why HIIT is not suggested for this particular person.
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But then you would never see me putting a obese person through HIIT or anything remotely close in the first place. Turn off The Biggest Loser.
Agreed.
I think educating a client on what signs to look for if they go over their threshold is absolutely important. Not every general client you meet wants to be worried with heart rate numbers and when it comes to getting someone to adhere to a program, keeping it simple always works best.
HIIT is a term that gets watered down a bit much. Originally it was mostly used for something where you'd nearly die from as the effort put into it was so much, and when HIIT got popular the term gets thrown around a bit too loosely.
Using a mix of RPE & HR is good. However, with this particular person it seems best to establish at what particular HR he is exerting himself to the level that he can still talk, but with some effort. I'm amazed and even appalled his former trainer had him put on a certain HR zone without even checking whether that zone was correct for him.
Good for you to check out if his difficulty with achieving that HR and having a lowish RHR might be due to his medication.
But like I said before, a low HR might be just as normal for him as it is for me. 160bpm would definitely be out of the question, unless it'd be raised artificially due to extreme stress.. (have seen such high HR only at the start of a mass event where speed did matter = 5000 cyclists around me at the same time)
Medicine reference site
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