From the Guidelines
You should consult with a healthcare provider about your elevated heart rate of 100 bpm, as this could be related to multiple factors including your COVID infection, weight gain, sedentary lifestyle, and sleep apnea. Start by gradually increasing physical activity - aim for 150 minutes of moderate exercise weekly, beginning with just 10-15 minutes of walking daily and slowly building up. Focus on weight management through a balanced diet with reduced calorie intake (500-750 fewer calories daily) and prioritize consistent CPAP therapy for your sleep apnea. Your elevated resting heart rate may be due to deconditioning from reduced physical activity, the inflammatory effects of COVID-19 which can persist as part of long COVID, weight gain increasing cardiac workload, and untreated sleep apnea causing stress on your cardiovascular system. At age 45 with these risk factors, a medical evaluation is important to rule out other cardiac issues and establish a personalized treatment plan that might include medication if necessary, as suggested by the American College of Cardiology 1. Improving these lifestyle factors will likely help reduce your heart rate over time.
Some key considerations in evaluating your condition include:
- Postural Orthostatic Tachycardia Syndrome (POTS), which may be a potential cause of your tachycardia, characterized by an excessive heart rate increase upon standing, as defined by the American College of Cardiology 2.
- The importance of ambulatory rhythm monitoring to exclude arrhythmia and define the pattern of heart rate elevation, as recommended by the American College of Cardiology 1.
- The potential for long COVID to contribute to your symptoms, including persistent tachycardia, as discussed in the context of post-acute sequelae of SARS-CoV-2 infection 3, 4.
- The need for a comprehensive medical evaluation to rule out other cardiac issues, such as myocarditis, pericarditis, or cardiomyopathy, and to establish a personalized treatment plan, as outlined by the American College of Cardiology 5.
Given the complexity of your condition and the potential for multiple contributing factors, it is essential to consult with a healthcare provider to determine the best course of action and to rule out any underlying conditions that may be contributing to your symptoms.
From the Research
Potential Causes of Persistent Tachycardia
- Persistent tachycardia, or a heart rate of 100 beats per minute, can be caused by various factors, including pre-existing sleep apnea, significant weight gain, and a sedentary lifestyle 6, 7.
- The combination of obesity and obstructive sleep apnea can lead to inflammation, insulin resistance, dyslipidemia, and high blood pressure, which may contribute to tachycardia 6.
- Discontinuing a weightlifting routine and gaining a significant amount of weight, such as 45 pounds, can also exacerbate these conditions and lead to tachycardia 7.
Impact of CPAP Treatment on Tachycardia
- Continuous positive airway pressure (CPAP) treatment has been shown to have beneficial effects on sleep quality and blood pressure in patients with obstructive sleep apnea, particularly in those with high CPAP adherence 8.
- However, the effect of CPAP treatment on lipid profiles is unclear, with some studies suggesting a decrease in total cholesterol but no significant changes in triglyceride, high-density lipoprotein, or low-density lipoprotein levels 9.
- Combining CPAP treatment with weight loss has been shown to improve blood pressure and lipid profiles in patients with obstructive sleep apnea, suggesting that a comprehensive treatment approach may be necessary to address tachycardia 7.
Role of Weight Loss and Lifestyle Modifications
- Weight loss has been shown to provide an incremental reduction in insulin resistance and serum triglyceride levels when combined with CPAP treatment, highlighting the importance of lifestyle modifications in managing obstructive sleep apnea and related conditions 6, 7.
- Adherence to a regimen of weight loss and CPAP may result in incremental reductions in blood pressure, suggesting that a comprehensive treatment approach that includes lifestyle modifications and CPAP treatment may be effective in managing tachycardia 6, 7.