Managing Beta-Blocker Side Effects in Obstructive HCM


Lifestyle Modifications That May Help

Certain lifestyle habits that may lessen the side effects of beta-blockers or help you manage them when they do occur.

Stand up in stages. To prevent a sudden drop in blood pressure, move from lying down to sitting to standing one step at a time, and sit or lie down right away if you feel dizzy, lightheaded, or faint, says Vallakati.

Crossing your legs, tightening your leg and buttock muscles, or wearing compression stockings (tight-fitting stockings that squeeze the legs) can keep blood from pooling in your legs and reduce dizziness, he says.

Stay hydrated. Dehydration can make the blockage worse and bring on shortness of breath, dizziness, or chest discomfort, says Vallakati.

Most people, including those with oHCM, don’t reach the daily recommended amount of fluid for their body weight, says Wang. Men should aim for 104 to 125 ounces (oz) (13 to 15.5 cups) per day, and women about 73 to 91 oz (9 to 11.5 cups) per day.

“Using that as a goal is important, but even going beyond that could be beneficial,” says Wang.

Drinking water can also help manage acute symptoms, says Vallakati. “Drinking about 16 oz (500 mL) of water rapidly can help raise blood pressure within a few minutes,” he says. It can be especially helpful first thing in the morning or after meals, he adds.

Keep your hands and feet warm. Wearing layers and warm socks can help if beta-blockers leave your hands and feet feeling cold.

Exercise moderately. Staying active helps maintain strength and fitness, while long stretches of inactivity can make symptoms worse over time, says Vallakati.

“Moderate, steady aerobic activities such as walking, cycling, or swimming are generally preferred,” he says. Sudden bursts of intense effort, heavy weight lifting, and straining while holding your breath can increase the heart’s blockage and trigger symptoms, he says.

Always check with your cardiologist before starting a new exercise routine.

Build a wind-down routine. Gentle stretching, deep breathing, or guided meditation before bed can help signal to your body that it’s time to sleep. Keeping your bedroom cool, dark, and quiet and skipping caffeine, alcohol, and heavy meals close to bedtime can also help.

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