Beta Blockers and Low Blood Pressure/Low Heart Rate Patients
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2.5 years ago
Daywalker • 240
@_245

I have low blood pressure (daytime of 103/63) and low resting heart rate (54 bpm). In fact, because my heart rate is less than 60 bpm that automatically means you have sinus bradycardia which happens to be a contraindication for the beta blocker class.

Is there anyone who has low blood pressure like me and sinus bradycardia (<60 bpm) but still took the beta blocker drops like Timolol and had no issues? What was the secret? Did it also impact your exercise as I know beta blockers can hamper one’s cardiac output so exercise (especially strenuous) can be harder?

beta-blockers • 1.2k views
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2.5 years ago
david 4.3k
@david_fe

Is there anyone who has low blood pressure like me and sinus bradycardia (<60 bpm) but still took the beta blocker drops like Timolol and had no issues?

I fit that category. My resting heart rate is similar to or lower than yours.

Did it also impact your exercise as I know beta blockers can hamper one’s cardiac output so exercise (especially strenuous) can be harder?

Initially I used Timolol at a dose of 3 drops per day. (Fortunately, I found better solutions very quickly so that I did not have to continue that dose.)

While I was using that dose, I took high amounts of ubiquinol (reduced form of CoQ10) and other cardiac support supplements. See this article, for some advice I offered 15 years ago that remains valid:

Use Coenzyme Q10 with Timolol Eye Drops for Glaucoma | FitEyes.com

I noticed a reduction in maximum heart rate while running, but curiously it did not affect my performance as far as I could tell. I was able to continue to set PR's. I heard a similar report last week from an endurance cyclist.

Exercise did not feel any more difficult. I did not really experience any recognizable side effects, but again, I was able to get off of that dose after a few months.

What was the secret?

I used non-pharmaceutical methods to manage my IOP (as discussed extensively on FitEyes).

This allowed me to reduce my Timolol to very small doses. After getting my lifestyle program (meditation, exercise, supplements, etc.) right, I only needed to take one drop of Timolol every 3-7 days. I monitored my need to take a drop via self-tonometry.

I continued my lifestyle program and I have not needed to use Timolol for years and I managed to reduce my IOP even further with new non-pharmaceutical methods (including PEAmium). Now I only need one microdrop (about 1/5th of a drop) of Zioptan daily instead of the 3 glaucoma drops I was taking (Xalatan, Propine 2x/day and Timolol 3x/day).

I have low blood pressure (daytime of 103/63)

My BP is not as low as yours. Timolol did not impact my BP as far as I could tell, but I don't tend to monitor BP as rigorously as I do IOP.

Here's another article from 15 years ago:

Managing My Blood Pressure and Eye Pressure While Sleeping | FitEyes.com

While I have had tremendous success managing my IOP, I still have not found anything that will bring my low BP up a bit (and I decided not to try increasing my salt intake because, as weird as it seems, that triggers allergies); I have not researched BP like I have IOP. Most of the ideas from the article immediately above did not work.

Maybe consider herbs for cardiac support and adrenal support as a starting point.

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Couple follow up question: 1.) When you initially used 3 drops per day - that was with or without microdosing? I don’t microdose at all, which I realize exposes me more to side effects from the drops.

2.) If I start on Timolol it will be only 2x a day max, and my 2nd dose no later than early afternoon. In that article about CoQ10 they used 90 mg. What do you recommend I take?

3.) What other cardiac support supplements did you take? And what dosages?

4.) How were you able to set PRs even though maximal heart rate was reduced? I am just curious on theories there.

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1.) When you initially used 3 drops per day - that was with or without microdosing?

Yes. That was well before I thought of the idea of microdosing.

If I start on Timolol it will be only 2x a day max. In that article about CoQ10 they used 90 mg. What do you recommend I take?

Personal opinion here, but I would use 200mg/day.

How were you able to set PRs even though maximal heart rate was reduced? I am just curious on theories there.

I don't know. I continued to work on my technique and other skills. I think my overall fitness continued to improve. Furthermore, years later I found out about running coach Phil Maffetone's low heart-rate training method that has been used with great success. (Lately Phil has picked up some strange ideas on nutrition and other topics, but that doesn't diminish the success of his low heart-rate training method for running.) My point is that the success of this program pretty much proves maximum performance does not require maximum heart rates.

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2.5 years ago
BrianB • 250
@brianb

My resting HR is 41-42, a consequence of 30+ years of heavy-duty cycling (racing). My BP can be all over the place -- on the high side during the day, but then can get low in the evening before bed (105/65).

I first tried Timolol a few years ago, and it had an effect on my cycling. I was not able to produce the same power (as tracked by a power meter), and would get extremely tired after intense sessions. If I was riding at a moderate pace, no problem. I did not know about doing punctal occlusion at the time. So I stopped using it.

About a year ago I started on Betaxolol, a beta blocker that targets different beta receptors. I didn't notice any exercise or BP impact, but then again I was not training super intensely.

Just about a month ago (as I just noted on the FitEyes list) I started trying Timolol again, but just once per day in the morning. I have noticed that my HR while on the bike is lower, and I would say, subjectively, that I feel like it probably has a performance impact. But I am not training to race these days, and I can still go out and ride 50-60 miles without a problem, and the Timolol seems to make a big difference in IOP.

It's not lowered my HR any lower than it already is (thankfully).

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