
by Richard Ellin
Question: So now that one of your advisers has been put on a beta blocker I’d like to know what the effects have been on their cycling. I’ve been taking beta blockers for 16 years and find that the lowering of my heart rate affects my riding, and I can’t get enough blood/oxygen to the legs unless I wait till most of the medication has warn off. Any suggestions? — Scott P.
Question: I am 57 years old and have been a mountain biker for the last 12 years. I took up road biking last year. I’ve ridden just over 1,300 miles this year so far. I’ve found my max heart rate usually is 181. My average heart rate is about 148. Are there any health problems with such heart rates at my age? I ride with guys who are 10 to 20 younger. Do you see any problems riding at this pace or should I look to back off a little? — David from Little Rock
Dr. Richard Ellin Responds:
Regarding the effects of beta-blockers on heart function, Scott, there is no question that they can reduce the magnitude of increase in heart rate with cycling (or any endurance exercise). For most cyclists, this would probably not be noticeable, but for competitive cyclists it could be noticeable at maximal efforts. Nevertheless, I would caution you, and any cyclists taking beta-blockers, not to stop or omit their beta-blockers without consulting with their doctors, since the effects of missing doses could be harmful.
Now, let’s talk about heart rates and, specifically, the benefits of certain HRs. For most recreational roadies, the approximate maximal target heart rate one should aim for during exercise can be estimated using the following formula:
Goal heart rate = (220 – age) x 0.85.
Thus, for a 50-year-old, it would be approximately 144. Most studies indicate that if one achieves this heart rate and maintains it through exercise, such as cycling, one gets the full cardiovascular benefits of training. There is little additional benefit in attaining higher heart rates.
Provided that one has a healthy heart, however, there is no danger in attaining heart rates in this range, or higher. The risk of attaining much higher heart rates, such as the 181 David asks about, is proportional to how healthy the heart is. Only if you have your heart thoroughly checked out by a physician, and it’s found to be in excellent health, would attaining a heart rate of 181 be safe.
For anyone questioning whether or not they have a healthy heart, only an exam (and perhaps some testing) by their doctor can determine that.
Richard Ellin, MD, FACP, is a board-certified specialist in Internal Medicine who practices in Alpharetta, Georgia. He received his medical degree and completed residency at Emory University, and has been in practice with Kaiser Permanente more than 25 years. He is also an avid cyclist.
This is a spot-on question for me. I’m 82 and’ve been a recreational endurance cyclist for 40 years. My family doc diagnosed chf about 3 years ago and I completely ignored it, as I felt nothing. I’ve also fought afib for about 15 years and have had 4 ablations (latest 9/22) at which point my EP prescribed 12.5mg of Metoprolol succinate daily. I don’t have valve or coronory blockage. My heart recently became much more sensitive to demand, and my HR would jump from mid 50s (sitting) to 100 just getting up and walking across the room. Saw my EP and learned I can safely increase my dosage. I’m now taking 50mg/day and my heart is responding more appropriately. The latest ablation has (at least temporarily) stopped the pesky afib. My pacemaker is an old model with 51 bpm as the minimum, and a slight “boost” with an inertia trigger. At night my hr flatlines at 51 (my natural low rate is 45).
I’ve been eyeing the new Empire State Trail that NY recently opened for a ride from Buffalo to Manhattan. Is this beyond the pale for a cyclist such as me?
That formula is for all users with all numbers of max heart rate or do you replace the 220 – age with your real max heart rate? My max heart rate is lower than 220-age so just checking.