Cardiac Rehabilitation: Medicine and Exercise

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Topic Overview

If you are in a cardiac rehab program, you are probably taking medicines for your heart and for other health reasons.

Some prescribed medicines can change your heart rate, blood pressure, and overall ability to exercise. It's important for your rehab team to know what medicines you take.

Give your rehab team a list of the medicines you are taking, especially if they cause any side effects during exercise.

Which medicines affect exercise?

This table lists medicines that you might be taking and how they affect exercise.

Effect of medicines on heart rate, blood pressure, and exercise

Medicine

Affect heart rate (HR)?

Affect blood pressure (BP)?

Affect 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 is present

Vasodilators

Raise HR

Lower BP (raises BP after exercise)

No

Anxiety and depression medicines

Medicines for anxiety or depression may affect your blood pressure and heart rate.

  • 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. If you are concerned about effects from your medicine, talk with your doctor.
    • Dual-acting serotonin and noradrenaline reuptake inhibitors may increase your heart rate and blood pressure.
    • Tricyclic antidepressants may lower your blood pressure or cause heart rhythm problems. These medicines are generally not prescribed for people who have heart problems.
    • Selective serotonin reuptake inhibitors (SSRIs) have few heart-related side effects.
  • 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.

Related Information

Credits

ByHealthwise Staff

Primary Medical ReviewerRakesh K. Pai, MD - Cardiology, Electrophysiology

Martin J. Gabica, MD - Family Medicine

E. Gregory Thompson, MD - Internal Medicine

Adam Husney, MD - Family Medicine

Specialist Medical ReviewerRichard D. Zorowitz, MD - Physical Medicine and Rehabilitation

Current as ofDecember 6, 2017