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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Verapamil & Excercise/Cardiac Effects
        
(Message started by: BILLY on Apr 1^st, 2003, 4:18pm)

Title: Verapamil & Excercise/Cardiac Effects
Post by BILLY on Apr 1^st, 2003, 4:18pm

Does Verapamil affect your ability to exercise/play sports either through low pulse, hypotension or other cardiac effects?

Is there a dose range where the cardiac effects or dizziness/constipation, other side effects become unmanageable or does your body really adapt up to the 240-1080mg doses I've seen listed?

Is there a Tips Section here for reducing Side Effects from the common CH meds?

thanks,

Title: Re: Verapamil & Excercise/Cardiac Effects
Post by Ueli on Apr 1^st, 2003, 8:12pm

Billy,
The fact that Verapamil is used to lower blood pressure does not mean that it does so for everybody. A too high BP is lowered by relaxing the over-tight muscles that constrict the vessels too much. Most people with normal BP are not affected in this way, although, for a few BP drops to the floor, resulting in some dizziness. If you do very heavy exercises, your target pulse-rate of 195 (or whatever it is) may be harder to reach. Constipation depends more on the individual than on the dosage, but if you watch your fibre intake, it is usually not a big problem.

Unless you're a professional sportsman, the tradeoff between performance and CH is entirely up to you. ;D

PFNADs
Ueli

Title: Re: Verapamil & Excercise/Cardiac Effects
Post by BILLY on Apr 4^th, 2003, 11:23am

Thanks I just wanted to hear it from actual patients who have taken verapamil for a while particularly young active ones. Here's a good review I found but was looking for confirmation from real active people.

Managing Hypertension in Athletes and Physically Active Patients

http://www.aafp.org/afp/20020801/445.html - Lists CCB class as no effect on training with specifics below:

" Calcium Channel Blockers. These drugs inhibit calcium slow-channel conduction, thereby reducing the calcium concentration in vascular smooth muscle cells, which results in decreased systemic vascular resistance with generalized vasodilation.19 Calcium channel blockers are effective in reversing ventricular hypertrophy.

Dihydropyridines such as amlodipine (Norvasc) and nifedipine (Procardia) can cause reflex tachycardia, fluid retention (pedal edema), and vascular headaches. *Nondihydropyridines such as verapamil (Calan) and diltiazem (Cardizem) can cause heart rate suppression, minor impairment of maximal heart rate, decreased left ventricular contractility, and constipation.5

Calcium channel blockers have no major effects on energy metabolism during exercise, and maximum oxygen uptake is generally preserved.20 There is a potential for competitive "steal" of muscle blood flow (because of vasodilatation) and earlier onset of the lactate threshold.30 However, calcium channel blockers, especially the dihydropyridines, are generally well tolerated and effective in physically active patients. They are often used as first-line agents in black athletes.5"

&

Tailoring Therapies for Active Patients

http://www.physsportsmed.com/issues/2002/03_02/lowenthal.htm

Calcium channel blockers. In normal, active persons, verapamil, diltiazem, and nifedipine exert adequate control during exercise, although a mild blunting of the diastolic blood pressure response to handgrip was observed with verapamil.51 In hypertensive patients, verapamil and nifedipine reduce systolic and diastolic blood pressure during exercise, perhaps by reducing systemic vascular resistance.52,53 There is no change in serum potassium levels between patients taking verapamil or nifedipine and those taking a placebo during isometric exercise.51

...Antihypertensive medications such as diuretics and beta-blockers can interfere with exercise performance, but others, such as ACE inhibitors, alpha-adrenergic blockers, and calcium channel blockers, do not and are well tolerated by active individuals. A combination of nonpharmacologic interventions, such as exercise and weight loss, may provide sufficient benefit to decrease cardiovascular risks independent of drug treatment."