Atenolol and diving

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seaangel

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Location
Martinez, GA
My physician started me on Atenolol for the tension headaches I had been getting over the last 3 months. I am running a Blood Pressure of 116/67 and a heart rate of 66 average since taking the Atenolol. Are there any side effects or contraindications to diving? My physician did not mention any. I do know that since starting the Atenolol last month I have not had any headaches. I am on a low dose of 25mg once a day.
 
Opinions from a couple of dive medicine experts on the atenolol:

1. Dr. Jules Eden:

"The common medical consensus is no you can't. The reason for this is that beta blockers such as atenolol or propranolol really reduce the heart's response to exercise. This wouldn't be too bad on terra firma but underwater it can create problems of fluid collection in the lungs called pulmonary oedema. There is also a risk of getting short of breath due to the drugs having a side effect of narrowing the bronchi of the lungs.

But having said that some diving doctors feel that if you can pass an exercise test and show that the medication has none of the above effects on you then you can be passed as fit."

2. Dr. Ern Campbell:

"Patients taking beta adrenergic blocking drugs may also have unique problems with exercise. These patients may have significant inability of the heart to respond to exercise; therefore, measurement of heart rate does not provide the index of exercise work load which is generally found in the patients who have normal autonomic responsiveness .

When stress testing a patient on beta blockade, a relative maximum heart rate can be achieved by comparing the perceived exercise score with the heart rate when the patient has significant fatigue. Heart rate response to exercise however, does not indicate a poor physiologic response in this case. There is some suggestion that beta adrenergic blockade will inhibit maximum exercise performance.

Diving should not provoke maximum work demand. However, it is important to advise divers taking beta blockers to avoid extreme exercise since their maximum capacity may by inhibited by beta blockade. Exercise testing should be done while taking the beta blocker and in the presence of the usual therapeutic regimen."

As you can see, both are conservative about diving while on a beta blocker.

Adverse reactions can include:

Serious Side Effects
Depression, shortness of breath, wheezing, slow heartbeat (especially less than 50 beats per minute), chest pain or tightness, swelling of the ankles, feet, and lower legs.

Common Side Effects
Decreased sexual ability; decreased ability to engage in usual physical activities or exercise; dizziness or lightheadedness, especially when rising suddenly from a sitting or lying position; drowsiness, fatigue, or weakness; insomnia.

Less Common Side Effects
Anxiety, irritability; constipation; diarrhea; dry eyes; itching; nausea or vomiting; nightmares or intensely vivid dreams; numbness, tingling, or other unusual sensations in the fingers and toes; abdominal pain; nasal congestion.

The possible adverse reactions involving compromised exercise tolerance, dizziness & signs/symptoms that could be confused with DCS seem of especial concern to the diver. If a diver experienced any of these features, they would want to inform their physician of such & seek renewed clearance to dive.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such. Seek clearance to dive from your physician.

Best regards.

DocVikingo
 
I have an appointment on Thursday with my Dr. and there is no way in you know what that I am ready to quit diving. I just have gotten started will be 2 years this May. So, she will have to change my medication, as I don't like the possible side effects.

I have only been taking it for one month, and it was to help relieve my headaches. My blood pressure and heart rate were not out of range prior to this. I ran mostly 130/80 and heart rates were 72-78. I think that the beta blocker may not be for me.

I do not have any problems with fluid retention. No swelling of the ankles, hands or face. So there must be another choice to try.

Is there any other medications that would have the same effect, that is to relieve the headaches and be compatible with diving.

Otherwise I want to be weaned off and try it without the beta blocker again. I have a couple of dives set up in February on a cruise vacation and I don't want to miss them. Plus, I have a liveaboard trip planned for Mach.

Please give me some suggestions I can take to the Doctor on Thursday.
 
I have been taking 25mg and diving for 5 years with no adverse effects. For the 1st 3 yrs. my Dr. insisted I take a stress test every year: always passed with flying colors. Stay fit and you should have no problems.
:)
 
Seadog, that is good to hear. I appreciate knowing someone that is diving with no noted problems. I still will be discussing this and my other options with my doctor on Thursday. I do work out and try to keep myself healthy. I just signed up at the Y, so I can take some of the step classes, yoga and most likely the Water aeorbics class.
 
SeaAngel

I have been on the same med. for many years and have had no problems. That said I had high B/P and that is why it was prescribed. I have had echo's and stress tests every other year and was running 3-5 miles every other day for years without problems. I did not hide this fact and was cleared by MD for diving.

I would ask your MD if there is another med that would work as your case is completly different.

I wish you luck and good diving,

chuckrt
 
I am posting the follow up from my physician visit regarding diving and taking Atenolol.

1)Exercise tolerance testing indicates I am well within a range of safety.

2) Physician comments: Healthy heart output. Physical condition is good. Continue exercise, diet and weight loss. Slower heart rate is within a very safe range 62-68. Also, can help prevent any anxiety or panic attacks. (Which I have never had I might add) But she feels that the slower heartrate may be good during a dive to prevent such.

3) A follow up visit in 3 months for labs, exercise tolerance and headaches. ( already have been one month without any)

I have added in a step areobic class one day a week and water areobics 3 days a week. My level of tolerance has been great. I have been in a heart target range with no problems. Fatigue level has improved and I generally feel healthier than ever.

My Doctor told me to go ahead and to the dives that I have planned in February. So I am going to do them.

I also, have lost 2lbs in the past week. I am using Weight Watchers and my goals are to lose 40 lbs. I also, check in with my Doctor once a month for this weight loss and she monitors my medications, diet and exercise. So not only will she see me in 3 months for the medical follow up I will be seeing her in one month for the weight. I get excellent medical following with regards to my health and fitness.
 
Thank you for the follow up.

Sounds like you've gotten a proper work up & that your physician has been able to make an informed decision.

Have fun.

DocVikingo
 

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