- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
Definition (3)
- Isolated systolic hypertension: A health concern?
- Blood pressure: Is it affected by weather?
- White-coat hypertension: When blood pressure rises at the doctor's office
Risk factors (2)
- Alcohol: Does it affect blood pressure?
- Menopause and high blood pressure: What's the connection?
Symptoms (1)
- Pulse pressure: An indicator of heart health?
Causes (5)
- Blood pressure: Does it have a daily pattern?
- Caffeine: How does it affect blood pressure?
- Blood pressure readings: Why higher at home?
- see all in Causes
Complications (1)
- Hypertensive crisis: What are the symptoms?
Treatments and drugs (5)
- Blood pressure medications: Can they raise my triglycerides?
- Calcium supplements: Do they interfere with blood pressure drugs?
- Diuretics: A cause of low potassium?
- see all in Treatments and drugs
Lifestyle and home remedies (9)
- Water softeners: How much sodium do they add?
- Weightlifting: Bad for your blood pressure?
- Blood pressure medication: Still necessary if I lose weight?
- see all in Lifestyle and home remedies
Alternative medicine (1)
- L-arginine: Does it lower blood pressure?
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Question
Beta blockers: How do they affect exercise?
My doctor recently prescribed a beta blocker to lower my blood pressure. Now, when I exercise, I have trouble getting my heart rate higher than 135. Is this normal?
Answer
from Sheldon G. Sheps, M.D.
Beta blockers slow your heart rate, which can prevent the increase in heart rate that typically occurs with exercise. As a result, the usual age-adjusted target heart rate doesn't work for measuring exercise intensity. No matter how vigorously you exercise when taking a beta blocker, you may never achieve your "target."
There's no precise method for predicting the effect of beta blockers on your heart rate. An exercise stress test can evaluate your exercise capacity on beta blockers and provide information on which to base an adjusted target heart rate. You can also try lowering your target heart rate by the amount that your resting heart rate has been lowered by the beta blocker. For example, if your resting heart rate has decreased from 70 to 50, then try working at a target heart rate 20 beats per minute lower than what you used to do. Again, this is not a precise method, and sometimes the peak exercise heart rate is affected much more than is the resting heart rate. An exercise stress test is the best way to establish a new target heart rate on beta blockers.
If you haven't had an exercise stress test, you can use the perceived exertion scale, which relies on your own judgment of how hard you're working based on effort, breathlessness and fatigue. The scale ranges from 6 (at rest) to 20 (maximal effort). For most workouts, your best bet is to aim for moderate intensity, or a rating between 12 and 14.
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