Firstbeat Life and Medications – What to Keep in Mind

With the aging of the population, more and more people have at least one chronic illness or condition, and medication is the primary form of treatment in many chronic and acute illnesses. In addition to prescribed medicines, pharmacies have more and more prescription-free medicines that people can buy, based on recommendations and their own judgment.

In most cases, use of medication does not disqualify a client from doing heart rate variability based Firstbeat Life measurements, but it’s important for both the professional and the client to be aware that certain classes of medicine can limit the reliability of the results.

The Firstbeat Life app does not ask the client to list their medications but enquiring about medicines and illnesses might be part of your routine background check with your clients. Having this information will help you establish a more comprehensive view of the client’s health status and make accurate conclusions about the Firstbeat Life result.

Medications that decrease the heart rate

The most common category of medicines that decrease the heart rate (HR) are beta blockers, used typically for coronary artery disease, high blood pressure, congestive heart failure and some arrhythmias. Beta blockers decrease the overall HR level and prevent the HR from increasing during exertion (or heavy stress). The medicine’s effect is based on blocking the hormone epinephrine (adrenaline), causing the heart to beat more slowly and with less force, which lowers blood pressure. As a result, the heart’s need for oxygen is reduced, which is the desired effect of treating the above-mentioned conditions.

If you know that a client is taking a beta blocker, we often recommend decreasing the person’s age-estimated max HR by 15-20 bpm. You can advise the client to do it in the application, under their profile information. However, there are large individual differences in how a person’s autonomic nervous system responds. Even if we know the general effect of beta blockers on HR, the reaction can vary depending on the effective ingredient, dosage, and individual response. Before decreasing the person’s max HR, take a look at the HR reactions during the client’s measurements, especially during exercise sessions, to see if the HR graph is very flat or if it increases “normally” during activity.

Medications that increase the heart rate

Medicines that increase the HR level are typically allergy or asthma medicines. When the condition is in good treatment balance, the body usually reacts quite normally, and interpretation of the Firstbeat Life result is no different when compared to an unmedicated situation. However, the differences (especially in HR level) between measurements with and without HR-increasing medicines can be significant, and thus, comparison of these results is not straight-forward and should be done carefully.

The effect of medicines that increase the HR can cause the Firstbeat result to look worse (“more red”) than normal, due to more stress reactions caused by increased sympathetic activity. And vice versa: medicines that lower the HR can sometimes cause “greener” than normal results, especially in the case of beta blockers. Because of this, it’s important that the professional is aware of the client’s illnesses and medicines and can take them into consideration in drawing conclusions of the result.

Interpretation of results

In general, if the illness is in treatment balance, the reliability of the Firstbeat Life result is good and can be interpreted as usual, even if the client is taking medicines. However, some illnesses, and the medicines being used to treat them, can cause the result to look worse, especially if they have an increasing effect on the person’s heart rate. Some antidepressants and mood medicines are an example of this. In these cases, the first priority is appropriate treatment of the illness, according to the medical professional’s plan. For the client’s well-being, the “more red” result in that situation is a side effect that can actually mean better overall condition and health.

Even if illnesses and medications might influence the measurement result, the effect of lifestyle and different daily behaviors on the client’s recovery status can still be assessed and demonstrated with Firstbeat Life, and progress, the effectiveness of set goals and action points as part of lifestyle coaching, can be monitored with regular measurements.

However, if there are a lot of acute and/or chronic illnesses and medications, the specialist needs to be aware that in specific cases, it might not be possible to draw reliable conclusions from Firstbeat Life, and thus, Firstbeat measurements should not be continued. In these cases, focus can be switched to other types of treatment and support.