Medicine and cardiac rehab

Some prescribed medicines can change your heart rate, blood pressure, and overall ability to exercise. So it is important to identify and understand how each drug can affect these measurements in order to safely exercise during cardiac rehab.

Medicine effects

Drugs

Affect heart rate (HR)?

Affect blood pressure (BP)?

Affect overall exercise capacity?

Angiotensin-converting enzyme (ACE) inhibitors No Lower BP No
Angiotensin II receptor blockers (ARBs) No Lower BP No
Antiarrhythmic agents May lower HR, depending on the type of medicine No No
Beta-blockers Lower HR Lower BP Decrease, but may increase if you have angina
Bronchodilators Raise HR No Increase capacity
Calcium channel blockers Raise or lower HR (depending on the drug) Lower BP No
Digoxin Lower HR No Increase, if atrial fibrillation or heart failure is present
Diuretics No Lower BP No
Statins No No No
Nitrates (nitroglycerin) Raise HR Lower BP Increase, if angina or heart failure is present
Vasodilators Raise HR Lower BP (raises BP after exercise) No

What about other medicines and exercise?

Many people recovering from heart conditions are clinically anxious or depressed. These symptoms usually go away within 6 to 9 months. But it is important to be aware of this risk and to be screened for signs of anxiety or depression. Medicines for anxiety or depression may affect your blood pressure and heart rate. Be sure your doctor knows what medicines you are taking.

  • Antidepressants may increase your heart rate as well as decrease your blood pressure at rest and during exercise. But some antidepressants can increase blood pressure.
    • Selective serotonin reuptake inhibitors (SSRIs) have few heart-related side effects.
    • Dual-acting serotonin and noradrenaline reuptake inhibitors may increase your heart rate and blood pressure.
  • Minor tranquilizers may lower both your heart rate and blood pressure by controlling your anxiety. They will probably not affect your exercise capacity.
  • Major tranquilizers may lower both your heart rate and blood pressure at rest and during exercise.
  • Lithium will likely not change your heart rate or blood pressure at rest or during exercise. This drug may affect your ECG by causing T-wave changes and arrhythmias both at rest and during exercise.

Last Updated: October 8, 2008

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