Tachycardia During Exercise, HIIT, and Exercise to Lower Heart Rate

Medical Q&A [Moderated]
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I am a 29 year old male who has been exercising regularly (weights three times per week and conditioning work two to three times per week) for a little over four months after a long period of living a sedentary lifestyle and being overweight. When I started I weighed 235lbs, had a waist measurement of 116cm, and a BMI over 35. I have gotten down to 202lbs, my waist is 99.5cm, and my BMI is down to about 30. From my mid teens up until three months ago I was a fairly light but regular smoker of cigarettes (I quit three months ago), and there was a period of about five years in my early to mid twenties when I was consuming far too much alcohol.

For the first three months of exercising I performed all of my conditioning work on my mountain bike, but about a month ago I started doing my conditioning work at the gym. I was using a treadmill with a heart rate monitor and after maintaining a jogging effort at about RPE 8 or so for five minutes the treadmill said my heart rate was 196bpm. My regular doctor was unavailable that week, so I consulted another doctor at the clinic I go to, she seemed quite concerned about my heart and referred me for an ECG, an echocardiogram, and a stress echocardiogram. I had all of these tests performed over the course of a month, during which time I continued to perform conditioning work twice per week but carefully monitored my heart rate in order to keep it under 180bpm. During the stress echocardiogram my heart rate rose to over 200bpm when jogging at an RPE of about 8.5-9. My resting heart rate prior to performing the test was 86bpm. To my surprise, the cardiologist did not seem very concerned about my working heart rate - he said it was quite high, but that this wasn’t particularly unusual given that I have a high resting heart rate and I am overweight. Last week I saw my regular doctor and all three tests came back normal - in fact, my doctor expressed surprise that his colleague had referred me for this battery of tests given my relatively young age and the absence of any other symptoms of cardiovascular disease. My regular doctor told me that, bearing in mind my weight and resting bpm, having such a high working heart rate was not particularly abnormal or concerning and that it should get lower if I continue to exercise regularly and keep losing weight, though he was unable to give me a time frame for when I should expect it to lower. He also told me that I could safely perform HIIT, but that I should try to avoid my heart rate going over 190-200.

My questions are as follows:

  1. Is my exercise induced tachycardia enough of a concern that I should make lowering my heart rate more of a priority than my strength oriented goals?

  2. Is there a time frame of regular exercise or a weight/BMI target whereby, if my heart rate has not come down by then, I should be concerned and seek further tests?

  3. I am on week five of the bridge. I have been performing GPP day 1 twice per week so far, though performing the steady state cardio at a higher RPE than 6. I am due to start incorporating a weekly HIIT day from next week. Should I follow the GPP as it is written, and if not what changes would you make for someone in my position?

  4. Is conditioning work more effective than resistance training for strengthening the heart and getting both my resting and working heart rate lower? If so, would you recommend that I add a third day of conditioning work per week?

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Congratulations on making all these major lifestyle changes. They will certainly pay off for you over the long run!

Obtaining an EKG was reasonable, though I am also a bit surprised at the stress echo being ordered. Regardless, it sounds like those tests all came out fine, which means we don’t need to be worried about this right now. If your EKG showed a normal rhythm throughout the stress testing, there is no reason for you to seek out further testing for this.

Based on what you’ve said here, I agree that it should improve with time as you get better conditioned. I would not exclusively focus on strength goals for now, but rather a combination of both strength & conditioning that meets the current physical activity guidelines at a minimum.

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Thanks for the reply, Austin. I really appreciate it!

With respect to the conditioning work, do you think I should be incorporating both steady state cardio and HIIT into my weekly routine? Also, in order to meet the current physical activity guidelines, would it be better to add a third conditioning workout or to increase the duration of the two conditioning workouts that I am already doing?

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Yes, I think both are worthwhile. My preference would be to add a third session if possible; if not, increasing the duration of your two existing sessions is reasonable.

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