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Can sporadic shortness of breath while beginning a long run and high blood pressure reading be a sign of pulmaonary arterial hypertension? and what medication is best for athletes who run long distance frequently?

Sometimes when I start out on a long slow run (10 miles) I have shortness of breath and rapid pulse the first 1/2 mile or mile and I have to stop running - other times there is no problem at all and I complete my long run at a 10 minute mile pace. I sporadically have above average high blood pressure readings (i.e 135 over 100) but other times it's normal.
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asked Nov 09 at 11:31AM in Cardiology/Heart Disease
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    answered Nov 16 at 08:02AM
    If you are diagnosed with hypertension and need to start medications, there are many options. Here is some general information regarding BP meds for someone who runs:

    Dihydropyridine calcium channel blockers (amlodipine, nifedipine, etc., but not diltiazem or verapamil) are often the first choice for athletes. An ACE inhibitor can be another good choice, though some people feel tired on them and don't want to exercise. Beta-blockers limit your heart's ability to keep up with exercise so they do not usually work as well for athletes. Diuretics tend to be poor choices as well, though some people do manage to tolerate them and still exercise regularly.

    Other factors may also override these concerns when choosing a BP med, but in most cases there is a lot of flexibility for the initial choice of medication.
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    answered Mar 08 at 01:52PM
    !35 systolic doesn't appear to be high if it is the result of exercise, and taking a hypertension medication at that point would have to be an extremely low dose so as not induce hypotension.

    I would be much more concerned about the high pulse rate. i have had that experience, and discovered that my blood volume was low, causing my heart to pump at a higher rate to obtain good oxygen profusion, thus, of course, raising the pulse rate higher than the physical activity would normally require, and also raising blood pressure.

    You could ask your physician to do the necessary tests to ensure that all is well with your body's renin-angiotensin system, which goes a long way in controlling blood pressure by controlling blood volume (extra-cellular water).

    In addition make sure you're well hydrated, and if you drink coffee, think about cutting back - it's a Diuretic. In fact before taking any Diuretic, over the counter (coffee) or prescription, I would talk to a physician who specializes in Sports Medicine.

    Running 10 miles in hot weather, even at the moderate pace of 10minutes/mile, can be life threatening if the runner is dehydrated, or as happened in the Boston Marathon some years back, has consumed to much water; two novice runners died of overhydration. Be careful, and read Wikipedia sites or find others.

    Hope this was helpful,

    Ross
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