Hopefully you are collaborating with his cardiologist as far a designing an exercise program for this man. There are specific exercises guidelines for individuals with heart disease or who have had a myocardial infarction (aka heart attack).
Beta blockers do the following:
1. Decrease resting and exercise heart rate.
2. Decrease blood pressure.
Please know that the normal exercise response is an increase in exercise heart rate and blood pressure. Hence you will not be able to determine how intense this client is working by measuring his blood pressure and heart rate. You will need to use RPE
You will also need to get clearance from his physician to exercise as he is HIGH RISK. If you don’t know the symptoms of angina, I would refer him to someone else.
This is a high risk client. Beta blockers will decrease both heart rate and blood pressure, like Joanne said. Using the Rating of Perceived Exertion chart is a great way to get a good idea of how hard the client is working. The trainer working with this client should require a physician’s approval and should request that that physician provide the client with set guidelines for his exercise program so that he can share that information with the trainer.
As an example of how the beta blocker will affect exercise, since the medication lowers heart rate, this client’s resting heart rate may be lowered, on average, by 20 beats per minute. Consider this when measuring his heart rate for purposes of calculating target heart rate. Just because his heart rate isn’t in the ideal range of what you would expect, consider the overall change that has occurred as far as stress on the cardiovascular system. Consider using the Karvonen Method for calculating Target Heart Rate.
Just to repeat what has been stated before: you need to have a physician’s approaval for working with this client.
The heart rate response is so altered by beta blockers that you can only use the RPE scale. If you use a heart rate monitor, you would find that the heart rate seems to hit a ceiling even when the client tries to work harder.
People on beta blockers often find that they feel tired and have low energy. You need to work around this client’s comfort zone.
Beta Blockers (as Joanne mentioned) lower heart rate and blood pressure.
Resting and Target Heart Rate are ineffective in this situation. The RPE scale is helpful but what Joanne and Marlan said is also true; this is a high risk individual and physician’s approval is necessary.
Hope this answeres your question.