Lifting After CHF?

After putting down the bar for over a year and not taking the best care of myself… About a month ago I was having having trouble breathing and sleeping, and constantly coughing. I decided to finally go to the ER and learned my blood pressure was astronomically high, 220/120 I think, and I was suffering from Heart Failure due to having untreated high blood pressure for so long, my kidney function was at 27% if i remember correctly and my heart was just dumping fluid in my lungs. Fast forward to today, I’m out of the hospital and doing well, struggling to eat low sodium but i’m making it work.

My question for you guys is can, or should I even try to start lifting again? Thanks to you guys and The Bridge I hit 400 in squats and deadlifts and 275 in bench.

I watched your podcast on blood pressure, and I am on metroprolol 50mg 2x/day, amlodipine 10mg 1x/day, hydralazine 25mg 3x/day, furosemide 40mg 1x/day. I take my blood pressure twice daily at home and it ranges from 150/80 up to 170/90, however like you said in your podcast I’m uncertain the cuff fits or I’m doing it wrong most of the time.

I’ve asked my Dr if he thought i’d be able to lift weights again. I’m not sure he understood what I meant by that. I’m a 31 year old male if that matters.

Sorry to hear about this - that is quite a complex situation to be in.

With that said, yes, if your condition is now stable, we would recommend exercise (both strength training and conditioning exercise).

(Additionally, although I know you didn’t specifically ask my opinion on this, but I would speak with your doctor/cardiologist about these blood pressure regimen. For someone with heart failure and chronic kidney disease, that regimen is less than ideal and is not consistent with clinical guidelines, unless there are specific reasons that you didn’t list here. There are a number of changes I’d be looking to make to this regimen given what you described)

Thanks for the reply!

Awesome I’m excited to get back under the bar.

Just out of curiosity, and if you have spare time what regimen would you prescribe? You had said in the podcast that taking one of those meds was like basically hamstringing yourself if I remember correctly.

​​Thanks for your time, love everything you guys do. Also thanks for what your guys are doing for strength training.

We can’t really make specific medication recommendations from here without knowing your medical history, but we would recommend speaking with your doctor about your blood pressure medication regimen to make sure that you are on the right stuff- particularly with respect to an ACE-inhibitor or ARB and some of the other meds here. Your doc may have a good reason for this regimen! :slight_smile:

Agree with Jordan. We don’t have enough information to give specific/individual recommendations.

In general with heart failure, we aim to get patients on an ACE-inhibitor or angiotensin receptor blocker (ARB), long-acting metoprolol succinate (rather than the short-acting metoprolol tartrate you may be on) OR carvedilol, and ideally not on hydralazine (unless being used as combination hydralazine/isosorbide dinitrate specifically for heart failure).

Thanks for the replies guys!

Seeing an actual cardiologist on the 7th, hopefully he will understand the need for gainz
At a follow up recently my blood pressure was 121/71 125/78 130/80 which is the lowest I think its ever been.
And to make a long story short I’ve been off a few of the pills for about a couple days to a week due to prescription renewal issues.
(needed a follow up appointment, but couldn’t get one due to not receiving my insurance card in the mail yet)

Some follow up questions if you guys see this, in your podcast you mentioned lowering salt/sodium only have an effect of around 8pts, does this hold true with heart failure? Or is it more about the damage to the kidneys? According to the doctors notes I had stages 1-4 renal failure and tubular necrosis. I’m not trying to go out and down a box of salt or anything like that, and I’m still keeping an eye on it, as hard as that may be.

The concern with sodium has more to do with the effects it has on water retention and blood pressure, particularly in “salt-sensitive” individuals.

A common recommendation for patients with heart failure is to aim for sodium intake below 3 grams per day, although this is based on expert opinion and limited, conflicting evidence, rather than on a strong evidence base clearly pointing to benefit. For example, there are no clinical trials showing benefit to a diet of 2 grams sodium restriction in patients with heart failure. In fact, more restrictive intake to 2 grams or less has been associated with harm in some studies as well. So all of this is to say that you are likely to hear a lot of advice on sodium restriction for heart failure, but the evidence base for this recommendation is limited, weak, and controversial.

Unfortunately I can’t speak to the kidney question here because I don’t have nearly enough information about your clinical course and where things have stabilized now, sorry. We’d recommend consulting with your physician on this matter.