Cardiac Rehabilitation: Medicine and Exercise

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.