BNLFL
Explorer
The reason for that is the dose is only 1mg, which is tiny.
Discontinuing reta
- Thread starter johnny01
- Start date
bamagirl26
Explorer
I'm up for a challenge!!
cujet
Explorer
Even though I've been an athlete for many decades, my HR was never especially low. A resting heart rate in the 80s (82 to 85) has always been typical for me. On Reta it climbed, with a peak RHR of 88. My guess is that Reta was responsible for a good 5 of that. On top of that, I got hurt when I fell off the roof of my truck. It's possible my heart went into AFIB.
AFIB is something I dealt with long ago, and the fall, the broken bones and the injuries were enough on their own to push my HR way up (adrenaline). It dropped back down in fits and starts over just under 24 hours (125, 85, 120, 85, 110, 85), and inside of a day it had completely returned to normal and was steady. I talked with my cardiolgist several times, and what I was told was to go to the ER if it hadn't settled within a day. That's because there is a 48 hour window for cardio reversion. Past that point, the procedure probably won't work.
My feeling is that Reta played a part in this episode. I've had plenty of dirt bike falls and crashes, and I even fell from the top of a helicopter during a preflight in awful weather. There was no AFIB following any injury, fall or broken bone until I began taking Reta.
I came off the top of the cab, roughly 8 feet up.
AFIB is something I dealt with long ago, and the fall, the broken bones and the injuries were enough on their own to push my HR way up (adrenaline). It dropped back down in fits and starts over just under 24 hours (125, 85, 120, 85, 110, 85), and inside of a day it had completely returned to normal and was steady. I talked with my cardiolgist several times, and what I was told was to go to the ER if it hadn't settled within a day. That's because there is a 48 hour window for cardio reversion. Past that point, the procedure probably won't work.
My feeling is that Reta played a part in this episode. I've had plenty of dirt bike falls and crashes, and I even fell from the top of a helicopter during a preflight in awful weather. There was no AFIB following any injury, fall or broken bone until I began taking Reta.
I came off the top of the cab, roughly 8 feet up.
bamagirl26
Explorer
Wow, I'm just happy you're alright — that is REALLY frightening!!
birdwhacker
Explorer
One thing to keep in mind: the downward trend is probably tied to your overall health getting better. While you're on reta, your true resting heart rate is almost certainly around 4-6bpm higher than your real baseline.
People who claim their RHR stayed the same simply don't have solid before-and-after measurements of it.
While taking reta, heart rate goes up a little, and once you quit it returns to baseline. There's no reason for concern provided you keep up with your electrolytes (potassium and magnesium). Skip those supplements and you could easily run into problems when reta is started.
lessthanhalf
Explorer
From what I understand, there isn't much published evidence yet regarding reta and how it affects cardiovascular safety. Ultimately, the key issue is whether it lowers the likelihood of heart attacks, strokes, heart failure and so on, no matter what it does to heart rate over the short or medium term. Sema and tirz do clearly cut the risk of death, death from cardiovascular disease, heart attacks, strokes, heart failure, chronic kidney disease and MASLD, even though they raise heart rate, though not as much as reta. The study cited below appears to indicate some risk reduction, but the effect is modest, the numbers are small and the follow up is too short. Data on this will emerge over the coming years. It certainly lowers the risk factors tied to long term CVD progression, but that is a different matter from possible adverse effects caused by raising heart rate.
With weight loss, reta will almost certainly bring resting heart rate down, and whether it ends up below the starting point is uncertain, but I do believe the early heart rate effects deserve consideration in people with arrythmias, since I have seen 3 people on this forum whose AF was triggered by starting reta, even if studies showing this are still scarce.
Should exercise heart rate rise far more than expected, or should exercise tolerance fall alongside a high heart rate, particularly if it goes above 220-age in years, then seeking an expert opinion could be wise, since it may be ischaemia, or impaired heart function, and chest pain does not always occur. I do wonder whether some people whose heart rate climbs a lot on reta, say 20 bpm, would do better on tirz instead, particularly if they are older or high risk, or at least until reta is proven to improve cardiovascular outcomes. Since the population using these drugs can carry high or even extreme cardiovascular risk from obesity and related metabolic syndrome, a degree of caution is probably sensible.
Reta currently occupies a historically unique spot: widespread use before approval or even before many of the required studies are finished. I am not sure of the number, but I doubt LILY's CEO estimate of 20,000 and all the bay area is correct, maybe a few hundred thousand or even a million or two worldwide, way more than in all the studies. Approval will almost certainly happen, but I do not think its cardiovascular safety can yet be called proven, and it might even end up with black box warnings about cardiovascular safety especially regarding arrythmias or even panic disorder. In some ways AI trawling of social media might produce more info on adverse effects than the studies, just because of the larger numbers involved.
From the triumph 3 study
"The 12 mg dose was also associated with a 37% reduction in triglycerides, a 17% reduction in non-high-density lipoprotein cholesterol, a 9.3 mmHg reduction in systolic blood pressure, a 19 cm reduction in waist circumference, and a 51% reduction in high-sensitivity C-reactive protein. 3-point and 5-point major adverse cardiovascular event outcomes trended favorably but did not reach statistical significance, a limitation the hosts attributed to the trial's relatively short 80-week duration compared with dedicated cardiovascular outcomes trials such as the 5-year REWIND study of dulaglutide. A properly designed cardiovascular outcomes trial will be needed to confirm whether the risk-factor improvements translate into fewer events."
With weight loss, reta will almost certainly bring resting heart rate down, and whether it ends up below the starting point is uncertain, but I do believe the early heart rate effects deserve consideration in people with arrythmias, since I have seen 3 people on this forum whose AF was triggered by starting reta, even if studies showing this are still scarce.
Should exercise heart rate rise far more than expected, or should exercise tolerance fall alongside a high heart rate, particularly if it goes above 220-age in years, then seeking an expert opinion could be wise, since it may be ischaemia, or impaired heart function, and chest pain does not always occur. I do wonder whether some people whose heart rate climbs a lot on reta, say 20 bpm, would do better on tirz instead, particularly if they are older or high risk, or at least until reta is proven to improve cardiovascular outcomes. Since the population using these drugs can carry high or even extreme cardiovascular risk from obesity and related metabolic syndrome, a degree of caution is probably sensible.
Reta currently occupies a historically unique spot: widespread use before approval or even before many of the required studies are finished. I am not sure of the number, but I doubt LILY's CEO estimate of 20,000 and all the bay area is correct, maybe a few hundred thousand or even a million or two worldwide, way more than in all the studies. Approval will almost certainly happen, but I do not think its cardiovascular safety can yet be called proven, and it might even end up with black box warnings about cardiovascular safety especially regarding arrythmias or even panic disorder. In some ways AI trawling of social media might produce more info on adverse effects than the studies, just because of the larger numbers involved.
From the triumph 3 study
"The 12 mg dose was also associated with a 37% reduction in triglycerides, a 17% reduction in non-high-density lipoprotein cholesterol, a 9.3 mmHg reduction in systolic blood pressure, a 19 cm reduction in waist circumference, and a 51% reduction in high-sensitivity C-reactive protein. 3-point and 5-point major adverse cardiovascular event outcomes trended favorably but did not reach statistical significance, a limitation the hosts attributed to the trial's relatively short 80-week duration compared with dedicated cardiovascular outcomes trials such as the 5-year REWIND study of dulaglutide. A properly designed cardiovascular outcomes trial will be needed to confirm whether the risk-factor improvements translate into fewer events."
AngieHolmes
Explorer
Because I've had to keep an eye on ultra-low bp for the past 6 months, I have solid data from before and after. My RHR is the same as it was. HRV is a mystery to me since I don't own anything that tracks it.
cujet
Explorer
The dog in the picture is Ian, an 11-month-old Norwegian Elkhound of mine, and he is a total blast of a pup!!
My Reta dose has been bumped up to 7mg weekly as of late. No noticeable HR shift so far. It appears to sit at about 88bpm.