Anyone aware of any dangers of heart meds & diving

[Gagedivers]

I saw a recent article in the Scuba magazine and it warned about diving while on meds. I am an medication for high blood pressure and high heart rate. While on the meds it is all under control. I asked my doctor if he felt diving was ok, and he wasn't real sure, but thought it was best to err on the side of conservative. That's all fine and good, but.... We are going to cancun in 2 weeks and, of course, the entire reason of this trip is to what? dive, of course...
I am taking 240 mg of Cardizem, 25 mg of Toprol, and 50 mg of Cozaar daily.
The concern my doctor had, is with the diving, the blood pressure may go to low and I could pass out! Not a pleasant thought...
He thought perhaps stopping the meds a day or two before diving might be okay. My thought, however, is that my blood pressure would go sky high when I'm not actually diving during those days ahead of time.
Does anyone have any words of wisdom. Have any of you dove while taking any of the above meds.
Thanks a bunch in advance :dazzler1:

 

[Bob3]

Tricky subject, luckily our own Diving Doc has a "drugs & diving database": http://www.scuba-doc.com/cvdrugs.htm
It's a good place to start to get yourself an introduction to the subject.
One of the BAD things about the typical "dive trip" is that the schedules involved usually load a person up to the hairy edge of the NDLs, not a good place to be.
You'll no doubt be hearing from some persons better versed on the topic than myself.
have fun, be safe, and welcome to the board.

 

[Cory_nw]

Hello Gagediver,
I take the following med's and had no problems diving,
Toprol XL 25 mg, Hydrochlorothiazide 25 mg, Warfarin 2.5 mg,
I check in with my Heart Doctor yearly and so far everything is
fine. So he has cleared me to dive. I live by Seattle and get in 2/4
dives a week. have fun in Cancun
cory

 

[DocVikingo]

You might find the following sites at Diving Medicine Online to be informative:

Hypertension & Diving
http://www.scuba-doc.com/hrtprb.html

Cardiovascular Drugs & Diving
http://www.scuba-doc.com/cvdrugs.htm

Best regards.

DocVikingo

 

[alwaysready2go]

Thank you for that link - it was very informative. We are in the process of becoming certified and was concerned about my husbands hypertension. He thinks because he is on medication and well controlled that he does not have "high blood pressure". I was just doing some research to make certain it is wise for him to become certified with me. Thanks for the link. I think we will still run it by his doc.

 

[Dr. Doug Ebersole]

Thank you for that link - it was very informative. We are in the process of becoming certified and was concerned about my husbands hypertension. He thinks because he is on medication and well controlled that he does not have "high blood pressure". I was just doing some research to make certain it is wise for him to become certified with me. Thanks for the link. I think we will still run it by his doc.

I'm a cardiologist as well as a diving instructor with an interest in diving medicine. While the vast of majority of patients with hypertension can safely enjoy scuba diving, there area couple of concerns. First, is this the run of the mill "essential hypertension" or is there a secondary cause of the elevated blood pressure such as kidney disease which would be more concerning? Secondly, does he have a thickening of the heart muscle (left ventricular hypertrophy)? This can be determined with an ultrasound test of the heart (echocardiogram). The recommendation is that people with this should not be cleared to dive. Finally, diving is usually a very safe and relaxing sport, but there can be a need to exert strenuously. Drugs such as beta blockers (Toprol, Atenolol, etc) blunt the heart rate with exercise. For this reason, it is recommended that patients on these medications have a treadmill test to demonstrate they can achieve a high workload (13 METS or approx 11-12 minutes on a standard Bruce treadmill test) in case this is needed during diving. ACE inhibitors (drugs ending in "pril" such as captopril, enalopril, monopril, etc) and Calcium channel blockers (verapamil, cardizem, procardia, Norvasc) are felt to probably be safe for diving.

PM me if you have further questions.

 

[GoBlue!]

Calcium channel blockers (verapamil, cardizem, procardia, Norvasc) are felt to probably be safe for diving.

Would you really include verapamil & diltiazem in that list, since they have negative chronotropic effects as well?

Jim

 

[Dr. Doug Ebersole]

Would you really include verapamil & diltiazem in that list, since they have negative chronotropic effects as well?

Jim

As the negative chronotropic effects are not as marked with verapmil and cardizem as with beta blockers they are not considered by the experts to be as concerning (reference: Medical Examination of Sport Scuba Divers, 3rd edition. Alfred A. Bove, MD, PhD, Editor)

 

[GoBlue!]

As the negative chronotropic effects are not as marked with verapmil and cardizem as with beta blockers they are not considered by the experts to be as concerning (reference: Medical Examination of Sport Scuba Divers, 3rd edition. Alfred A. Bove, MD, PhD, Editor)

Fair enough, thanks for the response.

Jim

 

[alwaysready2go]

DH is 39 and was put on accupril 10 mg a couple of years ago. His BP's then were 140's over mid 90's. He works in the construction trade so is very physically fit. The hypertension seems to be genetic as his Dad had a heart attack in his early 50's. DH is on cholesterol lowering drugs and aspirin therapy as well and followed by a cholesterol specialist as well as his primary care physician. He has not been seen by a cardiologist. I will have him speak to his dr. to get his take on it but from what I have read so far it seems like it should be ok for him to dive. Our thoughts right now are not to dive all the time but to be able to do so on vacations and such. Thank you for your thoughts on it.