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Cardiac Rehabilitation: Medicine and Exercise

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 or heart failure 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

By Healthwise Staff
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
John A. McPherson, MD, FACC, FSCAI - Cardiology
Last Revised September 27, 2012

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