Bald Paul

Posted on a club message board (names edited out). I was not the author. Having survived a heart attack at age 42, and having had multiple stents since (hereditary high cholesterol issues) I would never even consider the AOMM ride!

I will NEVER, EVER forget this ride!
This was the start of a beautiful but very challenging training ride for the Assault on Mount Mitchell 2019
About one-third of the way through the ride after climbing from Inman, SC to Saluda, NC via a challenging climb on Holbert Cove rd I called my wife from Saluda and told her I did not think I could finish.
She offered to pick my up but I insisted it was just a bad day and I needed to push myself. After getting my friends to wait on me to catch my breath we descended down to Tryon, NC and then proceeded to climb Hogback Mountain. At the top of Hogback I could hardly breathe. Well, I knew I was headed downhill into Landrum, SC so I thought all would be good.
Coming down 176 into Landrum doing 24+ mph the road started to blur. I was hoping not to crash but had no easy way to stop with traffic behind.
Luckily, my friends XXX and YYY talked me down the road keeping me on the right of the yellow line until we could pull over safely. I laid on the sidewalk in the gas station trying to get my breath. It was there I stopped...
Little did I know that I had a 98% blockage going into the right side of my heart and I was having a heart attack.
Thankfully, I was strong enough to pull through it and get the blockage removed. I love cycling but more importantly I love my family and friends.
Moral of the story:
LISTEN TO YOUR BODY.... It is OK to STOP.
I know we all push ourselves but when something seems off it is ok to call it. I should have stopped in Saluda 15 miles earlier and before climbing Hogback. It almost cost me.

noglider 

I turned 60 this year. My blood pressure is rising. My doctor is concerned. I'm measuring it every day now, and if I can't lower it in six weeks -- through reducing salt from my diet, cutting back on coffee, and increased exercise --, my doctor and I will talk about medication. It really scares me. I never had to do anything like this, and the dangers of high blood pressure make me worry. My grandfather died of a stroke, and my uncle had a stroke and recovered. My father died of an embolism.

Iride01 

IMO, it'll take more than just a reduction in salt and more exercise. How is your diet otherwise? Do you eat lots of green leafy vegetables? Plenty of stuff from the cole family, like Bush's hated broccoli? Beets and other red and orange fruits and vegetables too.

I've been just over the edge too with the doctor wanting to give me meds. Not so much for blood pressure, but for triglycerides. I just don't and won't take meds on a daily basis for anything more than a couple weeks, so I'll do whatever it takes with my diet and exercise.

noglider 

I have hereditary low cholesterol and triglycerides. My diet is excellent with lots of fresh fruits and vegetables, low alcohol (maybe one drink every two weeks), and a moderate amount of meat. In fact, I've been told I should eat more red meat as I'm sometimes anemic. I think the propensity to high blood pressure might be hereditary for me. And it scares the crap out of me. I've been so wonderfully healthy until now.

Iride01 

I used to think my cholesterol and triglycerides low by heredity too. Very low prior to my mid 50's. Then they started climbing and when I reached my 60's my doctor started getting concerned. Thankfully my BP is still normal to low.

jppe

If you have history of an irregular heartbeat or Afib this is a neat device. It’s made by Kardia and works super. You download an App to your Bluetooth device (smartphone) and put two fingers on each plate. It will give you an EKG and also tell you if your rhythm is normal or not. It’s really small and you can send the pdf to your doctor. About $90.

rsbob 

After reading most of this thread, I put on my vintage Polar HRM and enjoyed watching my HR on climbs and a couple of sprints. Got up to 170 on one 8% climb but kept it around 140 for most of the ride until the chest strap fell around by stomach and had a rate of 0. Will be tightening the strap and will mount the watch face on my handle bars versus on the wrist.

aissa

I am so inspired after reading your post. i actually have tears welled up in my eyes because i am constantly worried about having a heart attack. i had a calcium score reading of 96 (66 yr old female) and it has paralyzed me. You are a major encouragement. i wish i could emulate you, but it’s second best just to be able to read your post!
Please post more good stuff!!
Thank you for posting.

A

Artmo 

my calcium score was in th 90th percentile 10 years ago; I’m now 82. My cardiologist told to pay no attention to it, as it does not indicate a blockage, only calcification of the artery walls themselves. I’ve paid no attention and am still riding!

MoAlpha

This is correct and something which many people don't understand. Calcium score is a pretty good measure of cardiovascular risk, derived from large group studies and correlates with, but does not indicate, the presence of potentially dangerous plaques in the coronary arteries. If you want to know how bad your vessels are, get a CT angiogram.

staehpj1

My doc suggested that while everything looked good a CT angiogram would rule out potential risks. I wasn't worried to start with, but figured why not. I got a near perfect score so it was a bit more peace of mind. I think that was shortly after I turned 70 so hopefully it still looks good with my 72nd birthday coming up in June.

To be honest I tend to put more stock in the nice heart numbers for work outs and my low resting heart rate and good recovery time because they are something I can see every day.

In any case I figure I do what I can to live reasonably healthy and understand any of us can die at any time so I just enjoy each day.

WT21

Lately, yes. My head has felt light around 165BPM. Finding I have to keep it under 160 now.

rsbob 

You may want to get an EKG to rule out potential problems.

terrymorse 

Also, there may be some good news for us aging athletes. It appears that male masters athletes tend to have higher amounts of calcified plaque, but a lower risk of a heart attack. That calcification may be protective:

“Although marathon runners [and other masters athletes] have more calcium in their arteries, the plaques that they get seem to be much, much more stable than the plaques that normal people get, and this may actually protect them [against heart attack],” Sharma [St. George's University Hospital, London] said. “[It] may explain why so few marathon runners actually suffer a cardiac arrest and why people who exercise all their lives live longer than people who don’t exercise.”

Ref: Merghani et al, Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes With a Low Atherosclerotic Risk Profile, Circulation, July 11, 2017.

MoAlpha

The theory I've heard that makes the most sense is that the shear stresses caused by very high pressures and flow rates in athletes cause vessel wall damage which calcifies through a different mechanism than intimal plaque. I guess that might be reassuring to athletes with high Ca scores, but if mine looked ugly, I think I'd treat it as a warning. I know I've got a calcification in one of my carotids and I'm sort of scared to check.

MoAlpha

Lightheadedness with exertion is a serious heart problem until proven otherwise!

Carbonfiberboy 

Well, now I worry about my heart. I had a high calcium score, about 350, back in '17. Since October '22 I've had 2 syncopes at about 120 HR in spite of 2 cardiologists telling my there was nothing wrong with me that they could see from their tests. 2 stents later, no better, then a long-lasting nitrate med, no better, need a third opinion, this time from a sports cardiologist. Terrified my wife when I passed out on the rollers. No outside riding for me for a while.

MoAlpha

This is exactly what I meant. Serious, but not necessarily unfixable.

drbarney1

Use of a bicycle provides cardio to augment my amateur bodybuilding at age 76. Years of both activities probably had something to do with a good EKG and good echocardiogram. But more important, when I see men with big round bellies, something I protect myself against through structured exercise and diet, I know I would not want to live if I had to have that kind of a body. In the unlikely event the way I live would shorten my life I would still do it. Regular resistance training itself reduces the risk

of Alzheimer's by 80% and belly fat increases the risk. I'll take a heart attack with ten years subtracted from my life over rotting away in a nursing home.

fooferdoggie 

my body is so weird. when my esophagus went nova with pain (been hurting all my life) from taking Tylenol and anti inflamotires my BP went up. two days before it was normal then it was not and it has not gone back to normal in the 5 years since and even with my esophagus better then its been in many years. now everything makes it hurt all the meds to help it pain meds wearing a mask anything sweet or sour or liquid fat. I am testing out my first BP med. it made my esophagus Hirt so much I had to stop;. but I was sick at the time and I had to wait till it was feeling more normal to try again. first day I had really bad pains on my esophagus like I never had but stuck with it for three days and its a lot better. so maybe I can take this med though so far it has not helped but its been a little less then a week. riding helps it out though.

staehpj1

As others mentioned the 220 - age or other rules are just an average across the population. Individuals can vary widely. Additionally it isn't a measure of fitness. Even top pro racers can have high or low numbers compared to the average. What your number is it just is and doesn't change much with training. I know that the 220 - age always gave me a number that I could hit easily during even easy rides and never remember making a hard effort. Hard efforts I would always go way above the 220 - age number. Now in my 70s it is still the same. It doesn't mean anything fitness wise. It is true when I am fit and when I am out of shape. The difference it that I can go longer and recover quicker when fit. I can hit the same HR either way.

If your number was above average when young it will generally remain above average as you age. If lower it will remain lower. Also it just isn't something you train for.

Just going out and hammering up a hill doesn't necessarily get you to your max. The typical way to measure involves gradually increasing effort to get warmed up to maximum and often is done in a supervised setting. You can probably get along well enough without knowing the actual number. For most purposes it is a way to determine the various exercise zones. You can arrive at values for those zones well enough by how you feel on various rides and workouts and then looking at the data from those rides.

Gradually over time you can see what the highest number you hit while riding is, but your true max HR will probably be higher than what you actually see on a ride unless you are really getting warmed up optimally and then easing into the best effort. Still over time you may get a good idea of what your max is, even if it is likely a few points higher than you actually see.

PeteHski

I agree, although it's pretty easy to measure your HR max (assuming you have no medical conditions). A good 20 min warm-up, including a few very short high intensity intervals. Then all it takes is a handful of VO2 max intervals, typically 2-4 mins duration. You probably won't max out your HR on the first interval, but you will be pretty much there after 2 or 3 intervals with only short recoveries between them. e.g. repeated 3 min VO2 max intervals with 1 min recovery.

I also agree that your HR max is whatever it is genetically, regardless of your fitness. For me it's been 192 bpm for at least the last 5 years. When I was in my 20s I recall it was over 200 bpm, although I don't have any records from that far back. At FTP I'm at around 180-184 bpm (93-95% of my max). That percentage seems to creep up slightly with my fitness.

staehpj1

True, but I don't generally advise folks who aren't in pretty good shape to do so. I leave it up to them to figure out if they can/want/need to.

FWIW, for most of us in out 50s and up knowing what out aerobic and threshold zones feel like is pretty key and likely good enough for general fitness riding. How well you can carry on a conversation or even sing is a good indicator. I often use that rather than look at the HR monitor, but like the records for looking at later to evaluate the ride and also to look at longer term trends. Someone could fudge a max HR number that gave them the right threshold in their workouts and the data would still be useful for most general fitness riding purposes. I wouldn't have been satisfied with that kind of records when I was younger and racing, but these days (at 71) it would be fine if I didn't know any better.

terrymorse 

Try not to focus on max. heart rate, it's not that useful. And forget the 220 minus age rule, it is inaccurate.

It's far better to determine your lactate threshold heart rate, which is where your breathing starts to become heavy enough that you can only talk in short phrases.

Heart rate training zones are typically defined as a percentage lactate threshold (LT) heart rate.
Here are the "Coggan" zones:

• 1- Active recovery, <68% of LT, easy spinning
• 2- Endurance, 69-83% of LT, "all day" (multi-hour) pace
• 3- Tempo, 84-94% of LT, "spirited" riding
• 4- LT, 91-105% of LT, time-trial pace, heavy breathing
• 5- VO2max, >106% of LT, very hard effort, "ragged" breathing

I'm turning 65, my LT heart rate is about 150, and most of my rides have average heart rate in the 120s (zone 2).



I try to do a harder ride a couple of times per week, but not more than that. It takes longer to recover from those efforts, and recovery is key (especially for us olds--we recover more slowly).

staehpj1

The problem is that many (most?) software/devices want you to calibrate using a maximum heart rate. The good news is that you can fudge that by entering a MHR that gives you the Lactate Threshold you need.